POLICY MATTERS
Policy addresses
“upselling”concerns
Policy states expectations when
insured and uninsured services
are provided together
A
policy just approved by Council
provides explicit expectations for
physicians who bundle insured
services with uninsured services or
provide uninsured services as an alternative to
insured services.
In those instances when insured and
uninsured services are being proposed or
provided together or when uninsured services
are being offered as an alternative to insured
services, the College requires physicians to
clearly indicate for which services the fee is
being charged and to clearly and impartially
describe the differences between insured and
uninsured treatment options.
The Uninsured Services: Billing and
Block Fees policy’s direction to physicians
is partially in response to concern about the
practice in which some physicians “upsell” pa-
tients on uninsured alternatives or who offer
faster access to insured services when bundled
with uninsured services. The College’s In-
quiries, Complaints and Reports Committee
stated that it has addressed several complaints
in the past couple of years – most notably
arising in cases involving cataract surgery and
in the dermatology context.
The policy states that when physicians
propose or provide combined services to-
gether, the situation “is ripe for confusion and
EXTERNAL CONSULTATION
DATES HELD:
Feb. 28, 2017
to May 1, 2017
# OF RESPONDENTS:
118
BREAKDOWN OF RESPONDENTS:
CHANGES MADE IN
RESPONSE TO
70% PHYSICIANS
FEEDBACK:
13% PUBLIC
10% PREFER NOT TO
DISCLOSE
5% ORGANIZATIONS
2% OTHER HEALTH-
CARE ORGANIZATIONS
YES
NO
ISSUE 4, 2017 DIALOGUE
17