How to use it
Review one recent billing month.
For each item, mark yes only when the control is documented and consistently followed. “Usually” or “someone knows how” identifies a process gap worth addressing.
1. Eligible source activity
The process identifies activity involving enrolled patients of the FHO group.
The physician personally performed the time being claimed.
Uninsured services, work by other team members and excluded settings are removed.
The source record remains available after calculation.
2. Actual service date
Every hourly claim uses the calendar date the work occurred.
Time is not shifted to a convenient month-end or submission date.
Late or corrected source activity triggers a documented review.
3. Category classification
Q310A and Q311A direct care are distinguished by modality and physician location.
Q312A work is patient-specific and otherwise eligible.
Q313A work is qualifying clinical administration, not general business administration.
Ambiguous activities are held for physician review rather than automatically assigned.
4. Daily calculation
Minutes are accumulated separately for each category across the calendar day.
Fifteen-minute units and the eight-minute remainder rule are applied consistently.
The combined 56-unit daily maximum is checked.
The fee amount reflects the code’s units rather than $0.
5. Monthly controls
The correct 28-, 29-, 30- or 31-day monthly maximum is applied.
The combined Q312A and Q313A ratio is checked.
The separate Q313A ratio is checked.
Activity across clinics, systems or billing workflows is consolidated before limits are applied.
6. Review and retention
The physician can see source activity, credited minutes, units, limits and final claims.
The physician reviews and approves claims before submission.
Rejected or changed claims are reconciled.
A past calculation can be reproduced without relying on memory.
Three questions for the final physician review
- Do the categories and credited time fairly represent eligible work personally performed?
- Can I understand how the daily minutes became the submitted units and fee amounts?
- If asked six months from now, could the practice reproduce the same result from retained records?
What to do when the checklist exposes gaps
Start with the earliest weak link. If source activity is incomplete, a better calculator will not fix the record. If classification is inconsistent, document the decision rules and exception path. If limits are checked manually, add a repeatable calculation and physician-facing review summary.
The free FHO+ Billing Readiness Assessment converts these controls into an instant score and priority-gap summary.
Official sources
Rules and processing instructions can change. Confirm current requirements before submitting claims.
- Ontario Ministry of Health INFOBulletin 260308: FHO+ implementations for April 2026
- Ontario Ministry of Health INFOBulletin 260309: FHO hourly-rate payments
- Ontario Ministry of Health INFOBulletin 260501: hourly-rate payment processing update
- Ontario Medical Association FHO+ resource centre
- Ontario Medical Association FHO+ hourly-rate guide