Oscar and Quebec (RAMQ) Billing


Much of the Quebec billing information can be found online at: http://www.ramq.gouv.qc.ca/fr/professionnels/devlog/index.shtml
Most (if not all) of the info is in french, I will do my best to translate the relevant documents from french into english.

There is a process and forms to be filled out to become an approved provider of electronic data. This does not prevent or restrict access to information.

There is a set of 18 files which are available from RAMQ which perform billing data validation. Some of the files are in pairs with a prefix defining the type of medical practice. OM for Omnipractioner or SP for Specialist. The Oscar (tablename) is in brackets.
1) OMACTAGE, SPACTAGE: Services with age restrictions.
2) OMACCABI, SPACCABI: Services which can only be billed from an office (cabinet?).
3) OMACETAB, SPACETAB: Services which can only be billed by an institution (etablissement?).
4) OMACMODI, SPACMODI: Services with modifiers.
5) OMACROLE, SPACROLE: Services which are restricted by certain roles.
6) OMACUNIT, SPACUNIT: Services which can be billed by unit.
7) OMACVISI, SPACVISI: Services which can be billed in the "visit" section of the payment request.
8) OMACCSST, SPACCSST: Services related to the CSST (Commission de la santé et de la sécurité du travail / Health and Workplace)
9) SPROSPEC: Services for specific roles and specialities.
10) OMACTARI, SPACTARI: Services and values with effective dates.
11) OMACTMAX, SPACTMAX: Services that have maximum rates.
12) OMDESMOD, SPDESMOD: Service with modifiers, rates and effective dates.
13) CODEDIAG: (diagnosticcode) Diagnostic codes.
14) DIAGCSST: Diagnostic codes used by the CSST.
15) OMAACSST, SPAACSST: Services admissable by the CSST with effective dates.
16) NATUEMPL: I'm still working on the translation of this one...
17) MESSEXPL: Billing error messages.
18) OMNI_SPEC_YYYYMMDD.rtf: (billingservice_qc) Services Master List. This file was received in .rtf format and converted to RAMQACTS for import.

The following script loads the diagnosticcode table from the RAMQ coddiagn file

load data local infile '/usr/netshare/public/import/coddiagn'
into table diagnosticcode
set diagnosticcode_no=NULL,
description=SUBSTR(concat(@var1," "),6,80 ),