Key takeaways
Understanding key RAMQ billing terms—such as acts, remuneration by act, mixed remuneration, time slots, elements of context, dispensing sites and on-call availability—helps physicians submit claims accurately to meet billing requirements and limit the risk of rejected claims.
Medical billing in Quebec comes with its own distinct lexicon, so it’s no surprise many physicians, especially new ones, find it confusing.
RAMQ billing involves specialized terms, codes, and categories that directly influence how physicians are compensated for their services.
Regardless of your care setting, mastering these definitions will limit claim rejections, minimize lost revenue, and allow smoother cross-team coordination.
To simplify your billing process, we’ve compiled a guide to 11 essential RAMQ billing terms every doctor should know:
An act (acte) relates to a procedure or action performed by a physician. Each action is represented by a code, which corresponds to a specific rate. You can find these codes and rates in your RAMQ manual.
Mixed remuneration (rémunération mixte) combines two payment types:
This system applies only in specific practice sectors and designated institutions, subject to departmental authorization.
Note: It is only valid between 7 a.m. and 5 p.m. on weekdays, excluding holidays.
On-call availability (garde en disponibilité) refers to being available to respond to patient needs without necessarily being on site. Understanding your on-call category is vital to ensuring accurate RAMQ billing and fair compensation.
Quebec recognizes three types:
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This premium (majoration) rewards physicians working in regions with limited healthcare resources.
Different rates apply depending on territory and physician status. Temporary support or substitution work often qualifies for a minimum bonus.
Eligibility requirements:
RAMQ divides each day into specific time slots. Physicians must declare the slot or slots worked for proper compensation.
Standard time slots:
For medico-administrative functions:
Elements of context (éléments de contexte) clarify the conditions under which services were performed.
They can:
Physicians may select one or more elements of context for each billed service.
The dispensing site (lieu de dispensation) identifies where a service is provided.
It may differ from the physical location depending on the service arrangement.
Two types exist:
Also see: How to choose a RAMQ billing solution
The reference site (lieu en référence) differs from the dispensing site. It designates where responsibility for the patient or communication originates.
Examples include:
These are paid at an hourly rate, rather than per act, as they do not involve direct patient care. Physicians receive this type of remuneration for participation in:
Under remuneration by act (rémunération à l’acte), physicians bill directly for the services they provide. Compensation is based on the acts submitted for each patient encounter.
A professional reference identifies the healthcare professional who refers a patient for specialized care, diagnostic confirmation, or ongoing treatment.
Beyond terminology, medical billing can be cumbersome, and leads to wasted time and energy that’s better spent with patients.
Fortunately, Xacte is here to make your billing easier.
Xacte provides real-time recommendations on a wide range of possible errors and provides personalized support from live agents. You’ll access:
Now, go forward and use these medical billing terms with confidence. You’re ready for smarter billing.
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