Good Faith claims restored

December 14, 2023

Dear Members,

Our AMA agreement includes a letter of commitment for restoration of Good Faith claims, but the terms were not something that physicians could live with. Between the burdensome manual process and gaps in coverage for patients, it just wasn’t going to fly. It’s taken time, but your AMA representatives never gave up. Alberta Health has confirmed that Good Faith claims, under a new policy, will be billable as of February 6, 2024. Watch for more information in the new year.

The policy will use the claims submission process and redirect Good Faith claims to automatic claims processing (avoiding the overburdened manual assessment queue). The policy will also cover services both in AHS facilities (consistent with the commitment letter), as well as in community practices (a welcome addition). Retroactive claims will be accepted back to April 1, 2022.

Thanks to the physicians and sections who told us how issues with these claims were affecting some of our most vulnerable patients. I’d also like to thank Minister LaGrange, who has taken an interest in this issue since assuming her role.

Last week I introduced our new Key Issues Tracker (member login required). You can sign up to be alerted (KIT@albertadoctors.org) when updates are made to the page. Those who did so last week have already received the news about Good Faith claims. Sign up today to keep informed and up to date as soon as news happens.

Two quick updates:

REGISTER NOW: Family Medicine & Rural Generalists Town Hall – Wednesday, December 20, 6 - 8 p.m.

This town hall is an opportunity for members to learn about what the AMA Strike Team (member login required) has proposed to save and stabilize family medicine and rural generalist practices in Alberta.

Physician leaders from the Strike Team will inform attendees about progress in all three streams of work being executed under the MoU with government, including the AMA's proposal to government to 1) immediately stabilize family medicine and 2) implement a new funding model.

There will be a formal presentation followed by a moderated Q and A session. A recording of the presentation portion of the town hall will be posted on the AMA's Strike Team web page after the event. While the town hall will focus on primary care, it is open to all members.

REGISTER HERE

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Advocacy for acute care

We have put government on notice that acute, hospital and community specialist care is in crisis too. Shoring up primary care will help reduce pressures on ERs and hospitals and is a necessary first step, but there is urgent need for stabilization in acute care also. Weaknesses arising from long neglect and worsened by a booming respiratory virus season are growing. I have been seeking every opportunity available to let Albertans know what is happening as we call for desperately needed stabilization of acute care. Latest media interviews can be found on our website.

More news to come next week.

Regards,

Paul Parks
President, Alberta Medical Association