The purpose of this manual is to provide hospitals/health zones with a reference document outlining the policies, guidelines and processes for interprovincial/territorial hospital claims for insured in-patient and outpatient hospital services.
In accordance with the interprovincial hospital reciprocal billing agreements, hospitals providing insured in-patient and outpatient services to eligible residents of other Canadian provinces/territories are entitled to payment of hospital costs. All provinces/territories participate in the hospital reciprocal billing process.
Under the reciprocal billing agreements, insured hospital in-patient services are payable at the hospital's standard ward or ICU per diem rate, as established by the host province/territory. This per diem rate is all-inclusive, with exceptions for specified high cost procedures. Outpatient insured services and specified in-patient procedures are payable in accordance with the rates established by the Interprovincial Health Insurance Agreements Coordinating Committee (IHIACC).
Information on the reciprocal billing arrangement for physician claims is not included in this manual.
This policy is applicable to all approved British Columbia and Manitoba facilities.
This policy is enforced by Manitoba Health, Seniors and Active Living.