Important Notices
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16 Apr 2021
New Payment Policy for RAMQ Patients

Dear patient,

We hope this letter finds you well. The purpose of this letter is to inform you of a change in the clinic’s billing policy for services provided to patients covered under the “The Régie de l’assurance maladie du Quebec” (RAMQ).

Reciprocal billing agreements between the provinces, with the exception of Quebec, allow physicians to submit claims to Ontario Ministry of health and long-term care for most services provided to out-of-province patients. Since Quebec chose not to participate in the inter-provincial reciprocal billing agreement, Ontario physicians, when providing services to a patient from Quebec, have 2 billing options:

  1. Bill Quebec patients directly at the uninsured services rate. The patient can then seek reimbursement from the Quebec Health Plan (up to the rates payable for those services under the Quebec fee schedule) and/or private insurance, if applicable.
  2. Bill the “The Régie de l’assurance maladie du Quebec” which is paid at the applicable Quebec rates for the services rendered.

While most if not all clinics in the Ottawa region bill Quebec patients directly for services rendered, ByWard FHT physicians have, for several years now, opted to bill RAMQ directly as well as bill patients a non-refundable service fee. The purpose of the fee is to compensate for the rate disparity between Quebec and Ontario as well as to pay for the resources required to submit the claims.

Billing RAMQ directly has proven to be a labour-intensive process and because it is a paper-based process, it can be very difficult to trace and can often take several months before a provider is compensated.

After careful consideration ByWard FHT family physicians have decided to follow the same billing practice, when providing services to Quebec patients, as other clinics in the Ottawa region. As of May 1, 2021, Quebec patients, will be required to pay for services provided by their primary care provider.

For virtual (telephone or video) appointments, patients will be required to pay an initial base service fee at the time of booking.

If an in person visit is required, patients will be charged when registering for their appointment.

Depending on the reason for the visit, the invoice will be adjusted and patients will be required to pay the difference after the visit. Once payment is received in full the patient will receive a detailed receipt which they may submit to RAMQ (and or private insurance if applicable) for reimbursement.

We appreciate that this is a significant change to our process that may be difficult for some. If you are calling the clinic to express your concerns, please be patient, courteous and respectful when speaking to our staff. Your kindness is always appreciated.

  • Does this change in policy apply to visits with a specialist at ByWard FHT?

    Specialists are currently reviewing their billing practices when providing services to a patient from Quebec. Patients who are booked for an appointment and will be impacted by a change in policy will be notified of any changes.

  • If I paid the initial fee will I be refunded if I miss the appointment?

    If a patient misses their appointment, they will be reimbursed the initial amount, minus the missed appointment fee.

    ***Reminder: For virtual telephone appointments your provider is most likely calling from a blocked number and that patients should be prepared to receive a phone call from their provider at the scheduled time and to allow 30-60 min for possible delays. Providers typically will try to call at least twice if the patient doesn’t answer. If the call is not answered it will be documented and the patient will be charged a missed appointment fee.

  • If I cancel my appointment, with the required notice, will I be reimbursed?

    Patients who cancel their appointment with the required notification (see Appointment cancellation policy) can contact the clinic to request a refund.

  • How do I submit my receipt to RAMQ?

    For information on how to submit your paid receipt to RAMQ for reimbursement go to:

    Reimbursement will be at the RAMQ rate which will not cover the cost of the entire visit. RAMQ patients may want to consider purchasing supplemental private insurance. See link below for additional information.

  • If my initial visit is virtual, but if at the appointment, the provider instructs me to come to the clinic in person, will I be charged twice?

    Yes. A virtual consultation and an in person visit are considered 2 separate visits, regardless if for the same issue or on the same day. Receipts may be submitted to RAMQ (and or private insurance if applicable) for reimbursement

  • How much is the initial base fee?

    The base rate can be anywhere between 50$ to 120$

  • I already have an appointment booked after May 1st, will I be required to pay the difference when I register for the appointment or if virtual, will I be contacted to pay the difference?

    Yes, the new RAMQ payment policy will apply to patients who have an appointment after May 1st.
    Those who have a booked virtual appointment and have already paid the $25 visit fee, will be contacted prior to their appointment to pay the difference.

  • If I call today, and I'm only offered an appointment after May 1st, will the new RAMQ payment policy apply?

    Those who call for an appointment and are booked after May 1st, will be subject to the new RAMQ payment policy.

  • If I have other questions or wish to provide feedback regarding this policy who do I contact?

    We ask that you please submit your questions and or feedback by accessing our online feedback form at


  • Thank you for your understanding and we look forward to working together towards your health and wellness.


    The ByWard Family Health Team

    Operated by Ontario Partners in Health
    Ontario Partners in Health logo