Ultrasound and optical tomography services now covered by the Quebec public health care plan
Recipients: Group Insurance plan administrators who have plan members residing in Quebec
In Quebec, since December 29, 2016, all ultrasounds performed or evaluated by radiologists, including in private clinics, are covered by the Régie de l'assurance maladie du Québec (RAMQ). In addition, since January 26, 2017, the RAMQ also covers optical tomography of the eyeball by ophthalmologists, including in private clinics, with the exception of retinal imaging (Optomap).
The transfer of costs for these services to the Quebec public health system will help reduce pressure on group insurance plan costs. This is excellent news for you!
How does this affect claims submitted by your plan members?
Under Quebec law, the costs for these services cannot be billed to patients as these costs are now completely covered by the RAMQ.
As a result, iA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) now denies claims for these services submitted by plan members residing in Quebec.
Are there exceptions?
Yes. Claims for ultrasounds performed by a specialist other than a radiologist and for optical tomography performed by a specialist other than an ophthalmologist may be eligible for reimbursement under the group insurance plan, provided that the plan member has this coverage.
To ensure ultrasound claims are processed properly, plan members must make sure the receipts provided include the details listed below for the specialist who performed the ultrasound or produced the report:
- Full name
- Licence number
We strongly suggest that you pass along this information to your plan members by forwarding the attached communiqué.
If you have any questions, please contact your advisor or your iA Financial Group Account Executive.
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Your plan members can track their claims at any time on their mobile phone using the iA Mobile app or in My Client Space, our secure website. It's quick, simple and practical!