Are you up to standard? Charging for after-hours phone calls

If the call is for an insured service, physicians cannot charge additional fees. If the call is for an uninsured service, a conversation about fees must occur ahead of time between the physician and patient-it is not sufficient to have a message stating all after-hours calls are uninsured. This practice is not compliant with the Charging for Uninsured Professional Services or the Continuity of Care standards and could deter patients in distress from seeking appropriate and timely medical advice.

The Charging for Uninsured Professional Services standard states a physician:

• must take into account the patient’s ability to pay, as well as professional and administrative costs;
• must inform a patient or third party of any fee to be charged before the provision of an uninsured professional service; and
• must not charge a fee to the patient in advance for “being available” to render professional services.

A financial barrier cannot be placed between a physician and a patient who requires urgent care outside of regular office hours. Additionally, the Continuity of Care standard requires physicians have a method by which after-hours care (with capacity to assess and triage) can be provided.

Section 26 the Canadian Medical Association (CMA)’s Code of Ethics and Professionalism also states physicians must discuss fees for non-insured services with their patients and consider their ability to pay. CPSA endorses and expects Alberta’s physicians to follow the CMA Code of Ethics.

For further information on compensation when providing on-call services, physicians may wish to contact the Alberta Medical Association.

Questions about CPSA’s Standards of Practice can be directed to Chantelle Dick, Standards of Practice Coordinator, at chantelle.dick@cpsa.ab.ca.