Key takeaways
- Know how you're compensated: Understanding your payment model gets you paid correctly for the care you provide.
- Systems prevent headaches: A clear billing workflow reduces mistakes and creates consistency from day one.
- Document, document, document: Thorough clinical notes make it easier to justify services, resolve disputes, and stay compliant.
New physicians in Quebec commonly lose time and revenue because of five avoidable RAMQ billing mistakes:
- Treating billing as an administrative task
- Misunderstanding compensation models
- Starting practice without a billing workflow
- Missing submission deadlines
- Relying on incomplete documentation
After medical school, physicians quickly realize: professors didn’t train you for medical billing success.
Hours wasted managing rejected billing claims will drain your energy and restrict opportunities for professional or personal growth. Not to mention, hold up getting paid.
In Canada, 75% of physicians report unnecessary administrative tasks—such as through billing— worsening their job satisfaction. Paired with physicians leaving up to 7% of their billings unearned, there’s a danger that physicians are both losing time and revenue on inefficient billings.
Clinicians stuck in a “figure it out later” mindset save minimal time before submission and lose much time once claims are rejected.
But when new clinicians begin their careers using effective billing practices, the advantages compound. They have more time, more revenue, and more energy to support more energy.
This requires avoiding common mistakes that cause rejections. Read to discover five of them and ways to avoid their pitfalls.
Mistake 1: Treating billing as an administrative task instead of a core skill
Most new physicians spend years mastering clinical care, but few receive formal training in billing. This is understandable, but as a result, billing is often viewed as a back-office task to be figured out later.
In both time and money, that mindset is costly.
Billing affects how quickly you're paid and whether claims are accepted. It even dictates how much administrative work follows each patient encounter. Small mistakes lead to rejected claims and hours spent resolving issues.
Building billing knowledge early doesn't mean becoming an expert overnight. It means understanding the fundamentals of how physician compensation works, what information is required for RAMQ claims, and where to turn when questions arise.
- In Quebec, physicians must understand key billing principles from the start. For example, RAMQ generally requires claims to be submitted within 90 days of the service date.
Like any other professional skill, billing becomes easier with practice. The sooner you develop confidence in the process, the more time and energy you’ll devote to patients.
How to avoid it
Set aside time during your first year to learn the fundamentals of RAMQ billing. Understanding the basics early will help you avoid common mistakes and build confidence in managing your practice.
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Clinicians increase revenue by an average of 9.4% using Petal Billing. |
Mistake 2: Not understanding how you're paid
Before your first day in practice, it's important to understand how your compensation model works.
Whether you're paid through fee-for-service, hourly remuneration, mixed remuneration, or another arrangement, each structure comes with different rules, expectations, and opportunities.
In Quebec, physicians are generally compensated through one of three primary models:
- Pure Fee-For-Service (FFS): Physicians bill RAMQ for each insured service provided.
- Hourly renumeration: Compensation is based primarily on hours worked within eligible practice settings.
- Mixed remuneration: A combination of time-based compensation and fee-for-service components.
Note: The Quebec government has introduced structural reforms via Bill 106 to fundamentally shift family medicine away from strict fee-for-service. Physicians are encouraged to receive pay by “capitation,” where family doctors are compensated based on fixed annual rates per patient, as well as performance-based indicators, hourly rates, and/or smaller FFS components.
Many new physicians focus on clinical responsibilities and assume compensation will sort itself out. Unfortunately, this results in missed payments or compensation that doesn't fully reflect the work performed.
For example, physicians working under hourly or mixed remuneration arrangements may require specific administrative authorizations before payments are processed correctly. Missing administrative steps delays claims and limits physicians’ revenue growth.
How to avoid it
Review your compensation agreement before you begin practicing. If anything remains unclear, speak with your federation, workplace administration, RAMQ, or trusted billing advisor to better understand how you're paid.
See also: Choosing your RAMQ Medical Billing Software? 6 Questions to Ask
Mistake 3: Starting practice without a billing process
The first year of practice comes with enough uncertainty already. Billing shouldn't be one of them.
Many physicians wait until they begin seeing patients before deciding how they'll document encounters, manage claims, track payments, or handle administrative follow-up. By then, small inefficiencies often become recurring frustrations.
Before you start practicing, establish a workflow that fits your needs and reduces medical billing rejections.
This is especially important in Quebec, where physicians may need to manage patient identification requirements, service documentation, claim submissions, account statement reviews, and payment reconciliation through RAMQ.
A clear process limits errors, improves consistency, and makes it easier to stay organized during busy periods. Good systems support a stronger foundation for your practice as patient volumes grow.
Before you begin, ask yourself:
- Who will enter billing information?
- How will claims be reviewed?
- Where will documentation be stored?
- How will payment reports be monitored?
How to avoid it
Create a billing workflow before your first patient encounter. Answer the above questions and communicate your process clearly for current and new team members.
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56,000+ providers and administrators trust Petal to simplify their billing.
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Mistake 4: Missing deadlines for submissions
Submitting a claim is only one step in the billing process. Following up is just as important.
New physicians are often surprised by how much revenue us affected by missed deadlines or rejected claims. Further, these problems tend to compound, leading to more wasted time and higher likelihoods of future missed deadlines and rejections.
A claim submitted incorrectly may be fixable, but only if the issue is identified in time.
- In Quebec, timing matters throughout the billing cycle. RAMQ generally requires physicians to submit claims within 90 days of the service date. If a claim is refused or a discrepancy appears on an account statement, correction deadlines may apply.
Develop a routine for reviewing payment statements, monitoring claim status, and addressing problems promptly. Keep track of what was submitted versus what was paid to ensure that nothing falls through the cracks.
A few minutes spent reviewing payments regularly can prevent significant revenue loss and reduce the stress of discovering issues long after correction windows have closed.
How to avoid it
Develop consistent documentation habits early in your career. Clear, complete notes that accurately reflect the care provided make billing easier and support compliance requirements.
Mistake 5: Assuming clinical documentation is “good enough”
Clear documentation supports good patient care.
It also plays a critical role in billing accuracy and compliance.
When clinical notes are incomplete, unclear, or missing key details, it becomes difficult to support the services that were billed. This causes issues when correcting claim issues or participating in payment reviews.
- For example, supporting documentation is particularly important for Quebec physicians because they’re responsible for maintaining records that justify the services billed to RAMQ. During a review or audit, incomplete documentation makes it difficult to demonstrate that services were provided appropriately.
Develop the habit of documenting thoroughly and consistently from the start of your career. Your notes should accurately reflect the services provided and the clinical reasoning behind decisions. In the rare case of an audit, any supporting details you’ve added will prove invaluable.
Good documentation protects both patients and physicians. It also makes administrative tasks far easier when questions arise weeks, months, or even years after patient encounters.
How to avoid it
Schedule regular time to review your billing documentation. Here’s a solid billing timeline structure:
- Daily: Submit encounter data.
- 24–48 hours: Review automated flags.
- Weekly: Address rejected or returned claims.
- Monthly: Review rule updates with staff.
- Quarterly: Audit high-volume billing codes.
Start your career with a strong billing foundation
You’ve worked hard for years to get to where you are. Now, getting paid what you deserve is more important than ever.
Understanding how physician billing works in Quebec will help protect your compensation and avoid unnecessary administrative stress.
The good news is that you don't need to learn everything at once.
Get a full breakdown of RAMQ fundamentals, compensation models, documentation requirements, and billing timelines from our guide:
How to Get Paid as a Quebec Physician: A Billing Guide for General Practitioners
You’ll discover:
- RAMQ registration and onboarding
- Quebec compensation models
- The billing cycle from patient encounter to payment
- Common refusals and audits
- Income optimization considerations
- Tax and support resources available to physicians in Quebec
Download the guide and build confidence in your billing from day one.
FAQs: Medical billing for new Quebec physicians
Do physicians receive billing training during residency?
Many physicians receive limited formal education on RAMQ billing during training, making self-directed learning important during the transition to practice.
What is the most common billing mistake new physicians make?
Incomplete documentation, misunderstanding compensation rules, missed deadlines, and failure to follow up on refusals are among the most common issues.
How long do physicians have to submit claims to RAMQ?
In most circumstances, physicians must submit claims within 90 days of providing the service.
Why is documentation so important for RAMQ billing?
Clinical documentation supports the services billed and may be required during payment reviews, refusals, or audits.
How often should I review RAMQ account statements?
Review every statement as it becomes available and establish a consistent process for identifying refusals, discrepancies, and correction opportunities.
What should I learn first as a new physician in Quebec?
Start with the fundamentals: compensation models, RAMQ submission rules, documentation requirements, claim correction processes, and payment reconciliation.
