Assignment of Payment

An “Assignment of Payment” is a legal agreement by which an attending practitioner designates payment for his/her services to another party. In this circumstance, the designated party may use the attending practitioner’s practitioner number in combination with its own payment number when submitting claims to MSP. To authorize MSP to make payment to a designated party, the attending practitioner must complete and file an “Assignment of Payment” form. However, even though the payment has been assigned, the responsibility for the clinical service and its appropriate billing remains with the practitioner whose practitioner number is used.

Adequate Medical Records of a Benefit under MSP

Except for referred “diagnostic facility” services, a medical record is not considered adequate unless it contains all information which may be designated or implied in the MSC Payment Schedule for the service. Another medical practitioner of the same specialty, who is unfamiliar with both the patient and the attending medical practitioner, would be able to readily determine the following from that record at hand:

a. Date and location of the service.

b. Identification of the patient and the attending medical practitioner. 

c. Presenting complaint(s) and presenting symptoms and signs, including their history. 

d. All pertinent previous history including pertinent family history. 

e. The relevant results, both negative and positive, of a systematic enquiry pertinent to the patient’s problem(s).

 f. Identification of the extent of the physical examination including pertinent positive and negative findings. 

g. Results of any investigations carried out during the encounter. 

h. Summation of the problem and plan of management.

For referred “diagnostic facility” services, an adequate medical record must include:

a. Date and location of patient encounter or specimen obtained. 

b. Identification of the patient and the referring practitioner. 

c. Problem and/or diagnosis giving rise to the referral where appropriate. 

d. Identification of the specific services requested by the referring practitioner. 

e. Identification of specific services performed but not specifically requested by the referring practitioner, and identification of the medical practitioner who authorized the additional services. 

f. Original requisition or a copy or electronic reproduction of the requisition, in which the method for copying or producing an electronic reproduction must be approved by the Commission, the nature of the copy or electronic reproduction must comply with the intent relative to the form and content of the standard laboratory requisition, and must be auditable to the original source document. 

g. Where a requisition is submitted electronically, the electronic ordering methods must be approved by the Commission employing guidelines established jointly by MSP and BCMA.

 h. Where a written requisition was never submitted by the referring practitioner, the laboratory staff person who recorded the verbal requisition must be identified. The requisitions must be retained for 3 years.

 i. Results of all services rendered, and interpretation where appropriate. These data must be retained for 3 years.