Doctors' billing is 'ambiguous and confusing,' rules Quebec auditor general

The newest report from Quebec's auditor general claims the provincial governmenthas lost control of doctors'billing of clinical fees.

GuylaineLeclerc describes the current billing procedure for medical servicesin the public healthcare system as"ambiguous, confusing and misunderstood."

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TheQuebec Ministry of Health and Social Services and theprovincialpublic health insurance agency,RAMQ, do not have a "complete picture of the clinical fees billed to patients," according to Leclerc.

RAMQ has a list of 11,000 covered medical procedures. However, in Quebec, doctors are given additional funding when they provide care or treatment outside of hospitals to offset the costs of operating clinics.

Last year, the province provided$150 millionin reimbursements to doctors but itdoesn't keep track of what the money was used for, according to Leclerc.

Charging patients more

Quebec physicians are also charging patients above and beyond what they bill to RAMQto help cover costs for medical procedures.

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The reportemphasizes the fees for the same medical procedurevarygreatly from one clinic to another.

No tracking of extra billing

Leclerc foundsome doctors and specialists charge patientsnearly double for certain procedures performed in clinics. The report says one cliniccharged $125 for a vasectomy, while another billed patients$225 for the same procedure.

Some patients also shelled out money foradditionalfees in clinicsthat aren't authorized, according toLeclerc.

The problem lies in the fact that RAMQ fails to keep track of the total that patients pay annually in clinical fees.The government reported that Quebec patients pay close to $50 million annually, but Leclerc says that isn't based on any actual analysis.

Health MinisterGatanBarrette says a new law is set to address the problem of extra fees doctors charge to patients.

"The reason why there are accessory fees is simply because the law is unclear," Barrette said.

Recommendations

In her report, Leclercrecommends the Quebec health ministry establish a firm setof clinical fees that doctors can bill to patients.

She also suggests that RAMQinform patients on what kind of medical procedures and care for which they can be billed.