Contesting a physician’s fees

Conciliation and arbitration procedure

If a person has a dispute with a physician regarding the amount charged for professional services, they may submit a request for conciliation to the CMQ’s Syndic. The Syndic will inform the physician of the client’s request.

The Syndic’s role is to find a solution that is acceptable to both the client and the physician. This may involve a partial or total reimbursement of the fees.

Requests for conciliation are processed pursuant to the Regulation respecting the conciliation and arbitration procedure for the accounts of physicians.

Who can make a request and request form

A request for conciliation may be made by anyone who has to pay a fee to a physician, for example a patient, a lawyer, an insurer that requests a summary of the record or a third party who requests an expert assessment.

A request for conciliation of an account must be made in writing and sent to the Syndic. The client can also use the form below and send it to the CMQ once it has been completed and signed. If you have any questions about the conciliation process, please contact us at deonto@cmq.org.

Account conciliation request form 

Types of services

Services that are not insured by the Régie de l’assurance maladie du Québec (RAMQ), such as cosmetic procedures, non‑medically required services, filling out forms or administering medications. A conciliation of accounts may also be requested in relation to fees charged by a physician who does not participate in the RAMQ.

Deadlines

• For an unpaid account, there is no deadline, but a request for conciliation can no longer be made if proceedings for the recovery of debts have been instituted.
• For an account that has already been paid, the deadline is 60 days following receipt of the account.

Exceptions

1. If the physician has agreed with the client on a treatment plan payable in one or more instalments: a request for conciliation may be made within 60 days after the last treatment received and within a period of less than one year after receipt of the account.
2. If the RAMQ or another insurer refuses to reimburse an account, the deadline for submitting a request for conciliation is 30 days from the date of that decision, but less than one year from the date of payment of the account.
3. When the Disciplinary Council renders a decision that expressly calls into question the quality or relevance of a professional act that has been billed, the deadline for requesting conciliation is 45 days following the Council’s decision.

Outcome

If conciliation is successful, the Syndic informs the client and the physician in writing.

In conciliation fails, the Syndic sends the client a written report no later than 45 days after receipt of the request for conciliation. The report also informs the client of the possibility of requesting arbitration.

Arbitration

If conciliation fails, the client may request arbitration of the account within 30 days of receipt of the Syndic’s conciliation report. A fee of $50 is payable when arbitration is requested.

The request for arbitration must be sent (by mail or email) to Ms. Linda Bélanger, Assistant Secretary of the CMQ[PM1] .

Collège des médecins du Québec
Legal Services Division
Ms. Linda Bélanger
Suite 3500
1250, René-Lévesque Boulevard West
Montreal (Quebec)
H3B 0G2

Email: arbitrage@cmq.org

The arbitration council hears the parties diligently and renders its decision within 30 days of the hearing. The arbitration council may maintain or reduce the account in dispute and may also determine, where applicable, the reimbursement a party may be entitled to. To do so, it may, in particular, take the quality of the services rendered into account.

In its decision, the arbitration council must decide on the reimbursement of the costs for the request for arbitration. It may also rule on the disbursements related to arbitration, i.e., the expenses incurred by the CMQ to conduct the arbitration process.

The total amount of the disbursements, excluding the arbitration costs, may not exceed 15% of the amount subject to arbitration.