FHO+ Revenue Capture — Full-Service FHO+ Billing for Ontario Family Physicians

Q312 covers indirect patient care — reviewing lab results, following up on referrals, drafting patient instructions, coordinating care. Q313 covers clinical administration — EMR management, roster oversight, quality improvement activities. Both are new FHO+ codes introduced April 1, 2026, paying $80/hour in 15-minute increments. Before FHO+, this work was unpaid. Now it isn’t — if you document it. For a complete reference on all four billing codes, see the complete FHO+ billing guide.

It’s a per-unit fee for every validated 15-minute documentation increment our platform captures. The fee is $1.60 per increment — the same regardless of which billing code (Q310, Q311, Q312, or Q313) applies. Because Q312 and Q313 are codes that launched April 1, 2026, your starting baseline is zero. Every increment we document is time that would otherwise go unbilled.

This is a documentation processing fee, not a percentage of your OHIP revenue. OpsMed is compensated for validated workflow capture and documentation outputs — never for a share of your insured billings. You retain full control over which claims are submitted under your billing number.

Yes — and OpsMed makes you more defensible than manual tracking. The Ministry requires you to retain timestamped records for Q312/Q313 claims, even though start and stop times are not submitted to OHIP. OpsMed generates timestamped activity logs designed to support PHIPA compliance, stored in Azure Canada Central for every minute captured. Your submission is a clean daily total. Your audit backup is a complete, timestamped trail. See our audit defense playbook for documentation checklists and evidence requirements.

If you have an existing workflow, we measure it in month one and establish it as your baseline. The Documentation Processing Fee applies only to increments captured by our platform above that baseline. You keep 100% of what you were already documenting. Our job is to identify undocumented indirect care time — not take credit for what you’ve already built.

Our platform connects to your EMR through its secure API to read appointment schedules, timestamps, and activity metadata — not clinical note content. Nothing changes in how you or your staff use the EMR. Our platform works with OSCAR community edition (integration tested, OSCAR Pro API access pending), with Accuro and PS Suite support in progress. If your EMR isn’t yet supported via API, we can work from OHIP billing exports and appointment schedule data while integration is completed.

If you’re not satisfied with OpsMed during the first 90 days, we refund your platform fees. No revenue targets, no paperwork.

All data is returned or securely destroyed within 30 days of cancellation. Patient data is stored in our secure Azure Canada Central environment. AI-assisted features process only de-identified, anonymized data through enterprise AI services governed by Personal Health Agreements. No identifiable patient data is sent to external services. Enterprise AI providers do not use customer data to train models. OpsMed acts as a PHIPA agent — your patient data is yours, always.

No cameras and no microphones — ever. Our platform uses small wireless presence sensors (similar to smart home occupancy detectors) that detect whether people are in a room. They output a single data point: “room occupied” or “room empty.” No images, no audio, no video, no biometric data of any kind. The sensors are about the size of a smoke detector, mount with adhesive, and plug into a standard USB outlet. They connect to your clinic WiFi and are configured remotely. Clinics display updated Notice of Information Practices signage informing patients that anonymous room occupancy sensors are used for billing administration.

Our platform works with or without an AI scribe. If your clinic uses a VOR-approved scribe (like Empathia, Tali, or Scribeberry), the scribe’s encounter notes provide additional timestamped evidence — making your billing records even stronger. If you don’t have a scribe, our platform uses room sensors plus your EMR appointment data to capture direct care time.

Our platform’s billing logic — the rounding rules, cap calculations, ratio monitoring, and activity descriptions — is fully built and tested against every published FHO+ requirement. The pilot is about proving revenue capture in a live clinical environment and gathering physician feedback to refine the experience. You’re not testing broken software — you’re validating a working system in the real world, and you’re getting preferred pricing for doing it.

You are — physicians are always accountable for claims submitted under their billing number. What OpsMed provides is the strongest possible documentation to defend those claims. If the Ministry requests your records, OpsMed generates the complete audit file: timestamped activity logs, evidence source documentation, confidence ratings, and daily summaries — formatted for OHIP review. We support you through the audit process with documentation and technical explanation of how each claim was generated. The system is designed so that every auto-prepared entry has multiple independent evidence sources backing it.

After the 90-day pilot, service continues month-to-month. Cancel anytime with 30 days written notice. Sensors remain with OpsMed at the end of the engagement. Upon cancellation, all clinic data is securely destroyed per PHIPA requirements, and we provide a final export of your billing documentation archive. Platform pricing is locked for 12 months from your start date.

Sensors store data locally and sync automatically when connectivity returns. If an EMR connection or VoIP feed goes offline, our platform flags the gap, suppresses unsupported entries, and alerts both your clinic and our support team. You are only billed for validated increments that meet our multi-source evidence threshold — if we can’t document it defensibly, we don’t document it at all.

OHIP billing is complex, constantly changing, and rarely taught in medical school. A 2024 review found that over 90% of Ontario physicians had unclaimed billing errors within the past 12 months — missed premiums, undercoded procedures, and retroactive claims never submitted. FHO+ adds four brand-new time-based billing codes (Q310–Q313) to an already complex system. Our platform ensures that every eligible 15-minute increment is documented with multi-source evidence, so nothing falls through the cracks. The system doesn’t replace your billing process — it makes sure you never miss billable time that you actually worked.

Appendix A is the Ministry’s list of high-value primary care procedures that now qualify for 50% shadow billing instead of 30% — IUD insertions, skin biopsies, laceration repairs, immunizations, epistaxis treatment, and more. If your clinic performs these procedures on rostered patients, every encounter now yields significantly more passive revenue. OpsMed cross-references your encounter records against the Appendix A code list and flags anything being missed.