This form is used by physicians to request a billing number required for submission of electronic claims to Manitoba Health, Seniors and Active Living. This form is applicable to physicians licensed to practice in Manitoba. This form is processed by Manitoba Health Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Plague. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy compendium includes the global policies and procedures required for the Department of Health, Seniors and Active Living to comply with The Personal Health Information Act. This policy is applicable to all areas of the department. This policy is enforced by branch leads.  
Department/Crown:Health
Category:Health

This policy is intended to enable the receipt of Proposals from qualified Proponents meeting the requirements contained in the Request for Proposals. This policy is applicable to Proponents providing a Proposal in answer to the services contained within the Request for Proposal. This policy is enforced by Manitoba Health, Seniors and Active Living.

This form is intended to provide a statement about real, potential or perceived conflicts of interest of any entity that will provide the Services within the Request for Proposal, including all proposed subcontractors of the Proponent. This form is applicable to Proponents providing a Proposal for Services being requested in the Request for Proposal. This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Poliovirus. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy aims to provide a high-level, relatively succinct protocol that health care providers can use as a quick reference to deal expeditiously with post-exposure situations. This policy is applicable to health care professionals at initial contact of care who are knowledgeable in the assessment of blood or bodily fluid exposures as well as those responsible for providing follow-up care. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This policy serves to provide affiliating students with mental health care clinical/work experience at Selkirk Mental Health Centre. This policy is applicable to the Selkirk Mental Health Centre chief executive officers, education services manager, mental health nurse educators, education services coordinators, program managers, patient services coordinators, quality risk and innovation manger, staff and affiliating clinical instructors. This policy is enforced by Selkirk Mental Health Centre.

Category:Health
This form is used by practitioners to submit their banking information in order to facilitate direct deposit of their fee for service income from claims submitted. This form is applicable to all practitioners who submit fee-for-service claims for services rendered to Manitoba Health, Seniors and Active Living. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

The purpose of this policy is to provide a policy framework to all Health Authorities and Manitoba Health relating to Pronouncement of Death.

Last updated June 13, 2023.

Department/Crown:Health
Category:Health
This form is intended to submit reimbursment requests for prosthetic and orthotic devices and services.  This form is completed by prosthetic and orthotic suppliers for reimbursment of device and/or services provided to public.  This form is processed by Manitoba Health, Seniors & Active Living.

Department/Crown:Health
Category:Health
This policy describes the requirements of the Prosthetic and Orthotic Program in Manitoba.  This policy is applicable to eligible residents requiring eligible prosthetic or orthotic services as prescribed by a medical practitioner.  This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This policy provides guidance on the management of suspected anaphylactic shock by public health nurses in non-hospitals settings such as immunization clinics in schools and in the community. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health, and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy outlines provincial expectations for immunization competency. This policy is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy outlines standards in order to participate in the Provincial Immunization Program. This policy is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services.  This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This policy provides direction and support to CancerCare Manitoba, Diagnostic Services of Manitoba and to all Health Authorities and their contract facilities on the establishment of workplace health and safety programs within the health workforce. This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health

This form is used as a Selkirk Mental Health Centre patient key card sign out sheet. This form is available to Selkirk Mental Health Centre patients, members of their family and staff. This form is enforced by the Selkirk Mental Health Centre.

Department/Crown:Health
Category:Health

This agreement is to facilitate the safe and appropriate use of the Public Access Workstation for Selkirk Mental Health Centre patients. This agreement is available to Selkirk Mental Health Centre patients, patient's family, committee or treatment team. This agreement is enforced by the Selkirk Mental Health Centre.

Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Q Fever. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Rabies. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This form is used to update assessments of applicants on a waiting list for long-term care.  This form is applicable to Manitoba Health, Seniors and Active Living, the regional health authorities and the personal care home facilities.  The form is filled out by the attending physician and by the case coordinator.  The form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
This policy directs the procedures of The Protection for Persons in Care Office (PPCO), under the authority of The Protection for Persons in Care Act (the Act) related to its receipt and response to reports of alleged abuse and neglect of patients. This policy is applicable to hospital, personal care home or institution or organization designated under The Health Services Insurance Act. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

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.

Department/Crown:Health
Category:Health
This form is a paper claim that is used to submit claims for coverage under a reciprocal agreement to Manitoba Health for insured medical services rendered to an individual that has valid health coverage in another Canadian province or territory.  This form is applicable to alternate funded physicians submitting reciprocal claims to Manitoba Health for statistical purposes only (shadow billing).  This form is processed by the Claims Unit, Insured Benefits, and Insurance Division.
Department/Crown:Health
Category:Health
This policy summarizes the timing of administration of vaccines that will provide optimal protection from vaccine preventable diseases for individuals not previously immunized. This policy is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services.  This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy summarizes the timing of administration of vaccines that will provide optimal protection from vaccine preventable diseases for most individuals. This policy is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This form is a checklist of all documentations needed when claiming reimbursements for larviciding cost sharing between the province and municipalities at the end of each season. This form is applicable to larviciding program coordinators. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
This form must be completed and submitted to the department by individuals that are seeking a record of user activity showing accesses to their personal health information that is maintained in a departmental health information system. This form is applicable to all individuals seeking a record of user activity from the department. This form is processed by the branch that is responsible for the health information system in question. 
Department/Crown:Health
Categories:Application, Health
This form is intended to submit application for permission to operate a recreational camp. This form is applicable to members of the public. Health, Seniors and Active Living process this form.
Department/Crown:Health
Category:Health

This policy provides financial support for refresher courses for experienced individuals previously educated as registered nurses, registered psychiatric nurses, and licensed practical nurses. Nurses Recruitment and Retention Fund funding is provided in exchange for a 12-month return of service commitment. This policy applies to Nurses, Psychiatric Nurses and Licensed Practical Nurses. This policy is overseen by the Nurses Recruitment and Retention Fund Committee.

Department/Crown:Health

This Registration Form is to be completed when applying for Manitoba health coverage.

This form is intended for registration for benefits under Manitoba's provincial health insurance plan of new residents of Manitoba.  

This form is applicable to members of the public.

This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This form is intended to submit application for permit for new construction or alteration/ innovation of a recreational water facility by a project engineer. This form is applicable to members of the public. Health, Seniors and Active Living process this form.
Department/Crown:Health
Category:Health
This form is for the purpose of an owner of X-Ray equipment to register the equipment with Manitoba Health, Seniors and Active Living.  The owner is to notify the Radiation Protection Division of any new or change in equipment, its use or location prior to such change.  This form is enforced by CancerCare Manitoba.
Department/Crown:Health
Category:Health

This form is intended to notify Registration and Client Services staff of changes to existing registration files by persons covered by Manitoba Health.

This form is applicable to members of the public.

This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health

This document is part of the Go-Live Package for Electronic Claims Submission and provides supplemental information for submitting electronic claims, such as when remarks should be included with the electronic claim.

This information is applicable to all practitioners and their staff who submit claims electronically for services rendered to Manitoba Health, Seniors and Active Living.

This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health

This form is used for reporting adverse events following immunization. This form is applicable to physicians, nurses, and other health professionals working in public health, primary care, and other health care settings. This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This form is used for reporting suspected rabies exposure cases. This form is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This form is used by Manitoba Residents when they want to request a summary of their personal billing history. This form is applicable to members of the public. This form is processed by Manitoba Health Seniors and Active Living.

Department/Crown:Health
Category:Health
This form is used by practitioners and/or their billing staff to request an electronic user number, which is required in order to submit electronic claims for services rendered. The form also provides the option for the practitioner to request a listing of all patients and their demographic data that the practitioner has submitted claims for over the past two years. This form is applicable to all practitioners and/or their staff who submit fee-for-service claims for services rendered to Manitoba Health, Seniors and Active Living. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This form is used by physicians to request a registration number for a patient that presented without their registration card. This information is required for submission of an electronic claim to Manitoba Health, Seniors and Active Living for any services rendered. This form is applicable to physicians or their clinic/billing staff. This form is enforced by Manitoba Health Seniors and Active Living.
Department/Crown:Health
Category:Health

This form is used to Request Notification of a Legal Action or an Insurance Claim resulting from an accident or occurrence as a result of the negligence of a third party.

This form is applicable to members of the general public who have acquired hospital and/or medical services as a result of third party negligence.

This form is processed by Manitoba Health Seniors and Active Living, Insured Benefits/Insurance Division, Third Party Liability.

Department/Crown:Health
Category:Health
This form is intended to request information or services of the Registration and Client Services department by employees of The Public Guardian and Trustee. This form is for use only by staff of Registration and Client Services and The Public Guardian and Trustee. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This form is used to request prior approval for reconstructive/plastic surgery.  Some examples of services that require prior approval would be blepharoplasty, mammoplasty, otoplasty, rhinoplasty, and transgender health services. 

This form applies to the physician proposing to provide the service. 

This form is processed by the Claims Unit, Insured Benefits, Insurance Division. 

Department/Crown:Health
Category:Health

This form is used by personal care home residents and their families/representatives to request a review by Manitoba Health, Seniors and Active Living of their assessed residential/authorized charge.  This form is applicable to Manitoba Health, Seniors and Active Living, personal care home facilities and those residents requesting a review of their assessed residential/authorized charge and their families/representatives.  The form is filled out by the personal care home resident or their representative, by the personal care home facility and by Manitoba Health, Seniors and Active Living.  The form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health

This policy describes the requirements to initiate Drug Program Information Network set up and changes.  This policy is applicable to all pharmacy providers that require DPIN set up or changes.  This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This internal document is utilized to ensure all steps are appropriately completed with regard to Drug Programs Information Network set-up and changes.  This internal form is completed by Operational Support Assistants on Technical Helpdesk.  This internal form is processed by Manitoba Health, Seniors & Active Living.

Department/Crown:Health
Category:Health

This form is used by personal care home residents and their families/representatives to request a waiver of their assessed residential/authorized charge.  This form is applicable to Manitoba Health, Seniors and Active Living, personal care home facilities and those residents requesting a waiver of their assessed residential/authorized charge and their families/representatives.  The form is filled out by the personal care home resident or their representative, by the personal care home facility and by Manitoba Health, Seniors and Active Living.  The form is processed by Manitoba Health, Seniors and Active Living.

This guide directs pool operators to inform individuals wearing diapers in pool facilities (and their parents, guardians and caregivers) the requirements they must meet prior to using a pool. The guide is applicable to pool facilities and outlines the responsibilities of the pool operator and actions in case of fecal material in pool water. Health, Seniors and Active Living enforce the guide.
Department/Crown:Health
Category:Health
This form is intended to submit claim requests for finance assistance on purchase of orthotic shoes.  This form is completed by orthotic suppliers and applicable to members of the public under 18 years of age.  This form is processed by Manitoba Health, Seniors & Active Living.

Department/Crown:Health
Category:Health
This policy constitutes an agreement of the conditions under which personal health information from Manitoba Health, Seniors and Active Living will be disclosed to a researcher in accordance with the provisions stated in The Personal Health Information Act.     This policy is applicable to researchers that have received approval from the Health Information Privacy Committee to access personal health information. This policy is enforced by Manitoba Health, Seniors and Active Living.  
Department/Crown:Health
Category:Health

This form is completed by members of the public to advise Registration and Client Services staff where a person has been residing, for the purposes of establishing residency pursuant to the requirements of The Health Services Insurance Act.

This form is applicable to members of the public.

This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This guide serves as a reference standard and is applicable for public health inspectors, licensing personnel, licensees, and care providers to protect the health and safety of those in the residential care facilities. Health, Seniors and Active Living prepare the document.
Department/Crown:Health
Category:Health

This information guide is used by Manitoba Health, Seniors and Active Living to provide answers to common questions about personal care services and daily residential charges, such as rate determination, rate reduction and disposable income.  In addition, the information guide provides the table of residential charges that is used to calculate a resident's daily rate based on income.  The information guide is applicable to Manitoba Health, Seniors and Active Living, other departments within the Provincial government, the Regional Health Authorities, personal care home facilities, residents of personal care home facilities and their families/representatives and the general public.  The information guide is updated on an annual basis by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health

This policy defines the roles and responsibilities for all licensed aeromedical attendants and air ambulance pilots in the province of Manitoba. This policy is applicable to licensed aeromedical attendants and air ambulance pilots. This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health

This policy defines the roles and responsibilities for all licensed land emergency medical services paramedics in the province of Manitoba. This policy is applicable to licensed  emergency medical services paramedics. This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health

This form is an application for the Emergency Medical Services Rural and Northern Return of Service Initiative grant.  This form is applicable to qualified licensed primary care paramedics. This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Rubella and Congenital Rubella Syndrome/Infection. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Salmonellosis (Nontyphoidal). This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy provides additional explanatory notes and clarifications regarding the Pharmacy Agreement.  This policy is applicable to Manitoba Pharmacies.  This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
This policy describes the process and timing of product listings on the Manitoba Drug Benefits Formulary and/or the Manitoba Interchangeability Formulary.  This policy is applicable to all brand and generic products.  This policy is enforced by Manitoba Heatlh, Seniors and Active Living.

Department/Crown:Health
Category:Health
This form is used for obtaining permission and collecting relevant client immunization history before administering the seasonal influenza and/or pneumococcal polysaccharide vaccines. This form is applicable to physicians, nurses, and other health professionals providing immunization services. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
This policy addresses case and contact identification and management and other related public health issues with respect to Seasonal Influenza. This policy is applicable to physicians, nurses, and other health professionals working in public health, primary care, specialty care, community health and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health

This policy serves as a guide to provide specific instructions for the safe use of proximity (key) cards by patients and grey fobs by visiting family members so they can access the Acquired Brain Injury areas or the Dialectical Behavioural Therapy Area at Selkirk Mental Health Centre. This policy is applicable to the Selkirk Mental Health Centre treatment team staff and patients and their families. This policy is enforced by Selkirk Mental Health Centre.

This form is a referral to the Geriatric Program that provides specialized geriatric mental health services for individuals 65 years of age or older in adherence with set guidelines, which the Selkirk Mental Health Centre intake team reviews. This form is available to external agencies within the Regional Health Authorities of Manitoba. This form is enforced by Manitoba Health, Seniors and Active Living.

This policy serves to provide financial assistance for books and tuition up to a maximum value of $2,000 per academic year for Selkirk Mental Health Centre employees returning to school to upgrade their qualifications but does not apply to continuing education requirements for licensure. This policy is applicable to the Selkirk Mental Health Centre employee applicant, supervisors, managers, human resources and bursary advisory committee members. This policy is enforced by Selkirk Mental Health Centre.

Category:Health

This policy serves as a guide to ensure Selkirk Mental Health Centre staff working with Manitoba Review Board (Criminal Code) patients are aware of the Victim's Bill of Rights legislation and their subsequent duty to warn. This policy is applicable to the Selkirk Mental Health Centre treatment team staff, social worker and area secretary. This policy is enforced by Selkirk Mental Health Centre.

This policy serves as a guide to ensure transportation is available to Selkirk Mental Health Centre patients requiring non-emergent medical services via stretcher. This policy is applicable to the Selkirk Mental Health Centre physician, nurse and Selkirk Mental Health Centre staff escort. This policy is enforced by Selkirk Mental Health Centre.

This policy serves to outline Selkirk Mental Health Centre Acute Program description and admission criteria. This policy is applicable to the Selkirk Mental Health Centre on-call psychiatrist, medical director, practice lead psychologist, program manager and patient services coordinator staff members. This policy is enforced by Selkirk Mental Health Centre.

This policy provides guidelines for the collection, limited use and disposal of audio/video recording of patients at Selkirk Mental Health Centre. This policy is applicable to the Selkirk Mental Health Centre chief executive officer, privacy officer and all program staff. This policy is enforced by Selkirk Mental Health Centre.

Category:Health

This policy serves to ensure that relevant patient information and all required signed documentation is completed upon admission to Selkirk Mental Health Centre. This policy is applicable to the Selkirk Mental Health Centre treatment team and health information services and technology staff members. This policy is enforced by Selkirk Mental Health Centre and The Mental Health Act of Manitoba.

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