Your Mini Practice Profile: Insight into billing patterns and proactively addressing potential issues

The latest Mini Practice Profiles (MPPs) are now available for members to view online and provide a statistical analysis of your billings from the 2022 calendar year. MPPs are generated for physicians who receive fee-for-service (FFS) payments from the Medical Services Plan (MSP), including any settlements or retroactive payments issued as of March 31, 2023. 

The Patterns of Practice Committee (POPC) and Doctors of BC makes MPPs available so physicians billing MSP can see if their billing patterns are within the normal statistical boundaries of their peer group. The information is taken from the larger Physician Annual Profile database used by the Ministry of Health to track billing patterns and may be referred to during MSP audits.

Why view your Mini Practice Profile? 

• The MPPs provide valuable information that allows you to address any potential issues. Understanding the flags on your profile is important, as it may put you at a higher risk of an MSP audit.
• MPPs include all fee-for-service claims paid by MSP, on behalf of ICBC and WorkSafe BC (WSBC), which identified you as the physician who provided the service, or as the referring practitioner, in addition to Family Physician Services Committee (FPSC) and Specialist Services Committee (SSC) fee codes.
• Reviewing your individualized profile allows you to see if your billing patterns are within the statistical norm for your peer group. This enables you to address any potential billing issues early and proactively.
• It can also alert you to fees or services that are flagged. Flagging occurs when you are outside the norm with respect to some aspect of service provision or billing. Knowing this could allow you to act to avoid a potential audit.
• Understanding the flags on your profile can assist you in determining if you should make proactive changes to your billings.

Please click on the link to access your 2022 mini profile (login required). 

Type of Practice Determination

• The Type of Practice (TOP) is your province-wide comparison peer group into which you have been placed for that calendar year.
• Your TOP is determined by the type of services (fee codes) that you were paid for during that calendar year. In other words, TOP correlates with “functional specialty” as opposed to “specialty of record”.
• By classifying each of the MSP FFS items that a practitioner has billed, your type of practice can be determined by identifying the most commonly billed specialty.
  • Example: If the majority of earnings of a practitioner are derived from fees for orthopedic procedures, the practitioner is deemed to be in the orthopedic TOP regardless of the specialty on record.

Additional resources

• Doctors of BC provides members with additional resources such as webinars on billing tips, common billing errors, and information on the audit process. These resources can be found under Billing and Audits.
• A helpful video on Mini Practice Profiles. 
• For more information, refer to the FAQ’s and Glossary of Terms.
• Join Business Pathways’ informational webinar, Audit and billing education series: Introduction to understanding your Mini Profile on Wednesday, April 3, 2024, from 6-8 p.m.

Do you have questions, need support, or need help understanding your profile? Contact us:

Doctor of BC staff support: 
Tara Hamilton, Senior Advisor, Audit and Billing
Email: View Email Addressthamilton@doctorsofbc.ca 
Phone: 604 638-6058 | Toll Free: 1 800-665-2262