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e-Panel Survey Summary

Third-party Forms

Synopsis

Since the last Third-party Forms e-Panel in 2007, the Canadian Medical Association (CMA) has worked with the federal government to reduce the burden for physicians of completing forms on behalf of patients. This survey revisited the same topic, asking physicians about how they handle the third-party forms they fill out for their patients as well as their concerns about these forms. The results of the e-Panel survey are summarized below.

Survey – December 2016

The survey was sent to 3,689 e-Panel members (targeting resident physicians and practising physicians who are involved in patient care). A total of 663 responses were collected, for a completion rate of 18.0%.

Results

Most commonly completed federal and private third-party forms, time required to complete these forms, and billing practices

We provided e-Panel members with a list of 13 common forms and collected information on the regularity with which physicians have to fill out these forms for their patients. The CMA inquired about the following forms:

[1] Short-term disability claim form
[2] Long-term disability claim form
[3] Sick notes
[4] Canada Pension Plan disability medical report
[5] Disability Tax Credit Certificate (Canada Revenue Agency)
[6] Veterans’ Affairs disability benefit form
[7] Non-Insured Health Benefits prior authorization form (for First Nations and Inuit people)
[8] Health Canada Special Access Programme (Drugs) request form
[9] Canadian Adverse Drug Reaction Monitoring Program form
[10] Health Canada medical document for access to cannabis for medical purposes
[11] Medical Certificate for Employment Insurance: Sickness Benefits
[12] Medical Certificate for Employment Insurance: Compassionate Care Benefits
[13] Canada Child Benefit form

We asked e-Panel members how frequently they were asked to complete these forms. Our respondents were most often asked to complete sick notes: 67.7% of respondents had to fill this form out at least weekly (29.7% had to write a sick note more than 5 times per week and 38.0% had to write this type of note 1–5 times each week). The short-term disability claim form was the next most frequently completed form, with 42.3% of respondents reporting that they were asked to fill out this form at least weekly (5.3% received at least 5 requests per week and 37.0% received 1–5 requests per week). Our respondents reported that they were seldom or never asked to complete forms 6–13.

A follow-up question asked respondents how long it took them to complete the requested form. Seven of the 13 forms required 5–10 minutes to fill out. The quickest form to complete was the sick note: 81.3% of respondents (n = 469) completed it in 5 minutes or less. Forms that took longer than 30 minutes to complete were the long-term disability claim form, the Canada Pension Plan disability medical report and the Veterans’ Affairs disability benefit form.

The third question asked respondents who they charged for the completion of a third-party form. Respondents were given four options for each form: they could indicate that they charged the patient on a case-by-case basis, that they charged the patient via block fee (a predetermined amount charged to the patient to cover the cost of completing forms and other non-insured services), that they charged the third-party, or that they did not bill for the completion of the form.

Forms that were predominantly charged to the patient (on the basis of the case) were the two types of disability claim forms and the Disability Tax Credit Certificate. Forms that were predominantly charged to a third party were the Canada Pension Plan disability medical report and the Veterans’ Affairs disability benefit form. Other forms that were not billed to either the patient or a third party were forms 3, 7–10, 12 and 13 .

Nearly 90% of respondents either often refrained (65.2%) or sometimes refrained (24.1%) from billing their patients for these medical forms to avoid imposing undue financial stress on them.

When we asked respondents about their concerns about completing these forms for their patients, common themes that came up were the following:

  • issues related to billing patients;
  • issues related to billing third parties;
  • the growing administrative burden of completing forms; and
  • inappropriate form requests (from either third parties or patients)

Requests for other forms
We found that 68.9% of respondents were asked by their patients to complete forms that were not among the ones mentioned above. We received nearly 1,100 submissions of the other forms that physicians complete on behalf of their patients.

The additional forms most commonly requested by patients were:

  • fitness test forms (mentioned in 18% of responses);
  • provincial forms (mentioned in 10% of responses);
  • disability forms (mentioned in 7% of responses); and
  • insurance forms (mentioned in 7% of responses).

Concerns about completing third-party forms
e-Panel members had a great number of concerns when it came to completing third-party forms. The main ones are listed here:

  • 75.0% of respondents were concerned that completing forms took time away from direct patient care;
  • 74.8% of respondents did not like being unfairly placed in the role of adjudicator (where the patient thinks the physician is responsible for approving their benefits);
  • 66.1% were concerned about the lack of compensation for completing forms;
  • 63.4% of respondents were concerned by the number of inappropriate requests from third parties; and
  • 37.3% were concerned by the number of inappropriate requests from patients.

Respondents also cited some additional concerns they had with these forms, such as:

  • the administrative burden (e.g., frequency of requests, time involved, length of forms);
  • the vague or inappropriate requests for physicians (from the forms or from the patient directly);
  • the lack of standardization or poor design of forms; and
  • the lack of compensation and lack of standardized fees for completing forms.

Next Steps

The CMA will continue to work with the federal government and the insurance industry to simplify the third-party forms that physicians are asked to fill out and to reduce the number of these forms. The latest survey results will assist CMA in identifying opportunities to reduce the administrative burden of forms (e.g., sick notes) and will contribute to a revised CMA policy on third-party forms.

Respondents told us

“We DO have a professional responsibility to assess patients. Abrogating this is not good for the profession. I understand insurance/province needs info. Filling forms however is very time consuming, unfulfilling, poorly paid and takes away from patient care.”

“It puts me in a difficult position to bill the patient. We are seen as carers not a business that charges patients directly. It can cause tension in the relationship.”

“Completing these forms is time consuming at all levels in my practice — for the patient, the admin assistant who works with me and myself. Many of the questions we are asked require a bit of a guess approach to answering them.”

“Necessary inconvenience.”

Respondent Profile

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