Your Mini-Profile: Why you should read it

Issue: BCMJ, vol. 57 , No. 6 , July August 2015 , Pages 256 Billing Tips

If you receive fee-for-service payments from MSP, a Mini-Profile (a statistical analysis of your billings for that calendar year) will be generated for you annually. So why should you read it?

The Mini-Profiles are made available by Doctors of BC to all physicians billing MSP so that physicians can see if their billings are within the normal statistical boundaries of their peer group, which is determined by the type of services a physician was paid for during that year. This provides physicians an opportunity to identify potential billing issues that may require correction.

When any statistic on your profile is significantly different from that of your peer group, a flag will appear on the profile automatically. Flags are relevant only when they indicate a potentially unjustified and nontrivial departure from standard billing or practice patterns.

Although flags are not considered conclusive, they may trigger other inquiries, including possible audits through the Billing Integrity Program. Understanding the flags on your profile can help determine whether you need to make changes to your billings. For additional information about how to interpret the information provided in your Mini-Profile, read the 2012 Mini Profile – Explanatory Notes document at www.doctorsofbc.ca/sites/default/files/explanatory_notes_2012_profile_0.pdf.

Take the time to review your Mini-Profile and consider if there may be a potential issue with your flagged measures that could be avoided.
—Keith J. White, MD
Chair, Patterns of Practice Committee

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This article is the opinion of the Patterns of Practice Committee and has not been peer reviewed by the BCMJ Editorial Board. For further information contact Juanita Grant, audit and billing advisor, Physician and External Affairs, at 604 638-2829 or jgrant@doctorsofbc.ca.

Keith J. White, MD. Your Mini-Profile: Why you should read it. BCMJ, Vol. 57, No. 6, July, August, 2015, Page(s) 256 - Billing Tips.



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