When working with Teleplan, the language can be a bit tricky so we’ve put together a quick guide on the different MSP enrollment options, Opted In, Soft Opted Out, and Hard Opted Out, to help you decide which one applies to you.
Background
The Medical Services Plan of BC offers limited coverage for those on Premium Assistance. There’s a $23 benefit that can be shared between what MSP calls “Supplementary Benefits”.
Here’s what MSP says on the subject:
And a link to their page on Supplementary Benefits
Definitions
Opted In
This is the status of Medical Doctors and Midwives or any practitioner that bills only through MSP for their fees. These practitioners cannot collect any fees above and beyond the MSP fee schedule if they are Opted In.
Due to the nature of this status, it is very unlikely that a supplementary benefit practitioner should be set to Opted In.
Hard Opted Out
Hard Opted Out is the status of a practitioner who is collecting nothing from MSP but wants to allow patients to submit for the $23 premium. The practitioner can either fill out the forms themselves and mail them in, or they can send the submission in electronically.
If they are Hard Opted Out, the practitioner can submit MSP claims for a patient but the patient will be re-imbursed directly. So for allied health practitioners, they can bill MSP for the $23 premium assistance benefit but the payment will be sent directly to the patient.
Soft Opted Out
The vast majority of allied health practitioners would fall into the Soft Opted Out category.
Practitioner who are Soft Opted Out can both bill and collect the $23 from MSP and charge the patient a user fee on top of the covered amount. The $23 will be paid directly to the clinic/practitioner.
We hope this helps you better understand the different statuses in Teleplan. If you’d like to learn more, you can find more info on the BC government website.