About corporate consultations
Corporations and employers provide Maple access for their employees. For example, we’re the virtual care provider for several large companies like Bombardier, Ontario Power Generation, General Electric Canada and many others. We also work with a few notable insurance companies and service some or all of their clients, including Medavie Blue Cross, Green Shield Canada, Victor Insurance, and Morneau Shepell.
Corporate program set-ups
There are several set-ups for corporate consultations. In most cases, the “Reject” and “Emergency” buttons will be disabled. This means that similar to when providers see patients in a walk-in clinic, all presenting patients must be seen and assessed, even if the visit may not be treatable in the walk-in clinic.
Unlimited program (Reject and Emergency always disabled):
Many partner programs offer employees unlimited Maple General Practitioner (GP) visits. In these programs, the “Reject” and “Emergency” buttons will be disabled.
Capped models (Reject and Emergency sometimes disabled):
Some programs provide a limited number of visits to each employee (e.g., 3 Maple General Practitioner visits per year). For many of these, the reject and emergency buttons will be disabled, similar to the unlimited models. If the reject and emergency button is available, you can triage requests as you normally would and only accept those you believe are appropriate for virtual care.
Discounted rates (Reject and Emergency always available):
Finally, there are programs where patients receive discounted access to Maple GP visits. This means the patient is paying out of pocket and receive a discount on Maple’s publicly posted fees. The “Reject” and “Emergency” buttons will be available for these consultations.
We ask that you triage these requests as you normally would and only accept those you believe are appropriate for virtual care. If you pick up one of these visits and in the first 5 minutes determine you are unable to help the patient virtually, you can advise the patient and proceed to ‘Complete without charge.’
Expectations for corporate consultations with reject and emergency disabled
Employers understand that there are limitations to virtual care; however, they are paying for their employees to have timely access to speak with a provider for care or counselling on how to manage their medical issues, even if it cannot be resolved virtually.
For corporate consultations where the “Reject” and “Emergency” buttons are disabled (scenarios A and B above), you will only have an option to “Accept” the consultation. You are expected to accept the consultation and provide appropriate care based on the patient’s presenting condition. Providers will be paid the full consultation rate for their time in these situations by adhering to the following guidelines.
In most cases, the patient simply wishes to have a conversation with a provider who can provide some peace of mind on how urgent their issue is or where to seek care, even if the particular issue cannot be fully resolved virtually. In these cases, please spend a minimum of 5-10 minutes following the approach as outlined below:
If the request is for a concern that cannot be treated or resolved virtually, begin by sharing a brief disclaimer to let the patient know that their case needs to be assessed or treated in person, including why and that you’d like to hear more about their concern.
Hello, my name is Dr/NP [XX]. Before we start, I need to inform you that virtual care has some limitations. Based on your request, your concern cannot be treated or resolved virtually. I would like to hear more about your concern and help you find the best way to get the care you need in person. Can you please tell me more about what's bothering you?"
Set expectations with the patient that you will spend 5-10 minutes discussing their case and answering any questions they may have. As for all Maple consultations, providers are expected to take a basic history, listen to the patient’s concerns, provide some counselling on what could be wrong and advise the patient on next steps, including the urgency with which to seek in-person care if necessary.
I can spend 5 to 10 minutes discussing your case and answering any questions you may have. First, I need to ask you some basic questions about your medical history and your current symptoms. Then, I will give you some information about what could be causing your problem and what you can do to manage it. Finally, I will advise you on whether you need to see a doctor in person and how soon you should do that. Does that sound good to you?
After the discussion, you can offer to write the patient a custom “referral” note or write it in chat outlining your differential diagnosis and recommended next steps. Inform the patient that Maple can provide a copy of their consultation summary to the clinic where they seek care, including any notes you've made, so they do not have to outline their case in detail a second time.
Thank you for sharing your symptoms and concerns with me today. Based on our discussion, I have a few possible diagnoses that could explain your condition. However, to confirm the diagnosis and start the appropriate treatment, you need to be seen in person. I can write you a note summarizing our conversation and my recommendations. This way, you don't have to repeat yourself when you seek further care. Maple can also send a copy of this consultation summary to the clinic of your choice, so they can access the notes easily."
End the consultation by asking if the patient’s questions have been answered.
We have discussed your condition and plan for the next steps. Do you have any questions or concerns about what we have talked about? Is there anything else you would like me to explain or clarify?"
Completing a corporate consultation with reject and emergency disabled
For consultations that cannot be resolved virtually, but you’ve provided counselling to the patient, addressed their questions, and advised them on the next steps per the above guidelines, please mark the visit as "Complete" and charge for the consultation. You’ll be paid the full consultation rate.
Corporate consultations that do not meet these guidelines may be subject to payment revocation. Examples include but are not limited to:
Sending messages and closing the consultations without allowing the patient to respond
Consultations accepted and closed within 5 minutes, with very few messages exchanged
Ignoring a patient's request for a video or audio chat
Not actioning consultations in the triage queue, allowing the timer to pass to ‘skip’ the consultation.
Patient no-shows
Because the intent of this policy is to help you be available to the patient regardless of whether the specific issue is suitable for online care, the primary consideration is your time rather than whether or not a full consultation took place. As such, you are to be compensated for your time even if the patient never shows up, under the expectations outlined below.
When in a consultation where the patient is absent, you are eligible to complete the visit with charge when all of the following criteria are met:
You spend a total of 10 minutes waiting in the active consultation room for the patient;
Before completing the visit, you leave a message inviting them to resubmit their request when they are available.
If the patient arrives in the consultation before the 10 minute waiting period has elapsed, please conduct the consultation as normal per the abovementioned criteria.
Maple policy on in-person care
Some physician Colleges across Canada have updated their telemedicine/virtual care standards of practice to include new guidelines around appropriate referrals to in-person care.
To support physicians practicing on Maple, the Clinical Operations team has formalized relationships with in-person clinics and has outlined guidance for referring patients needing in-person assessment to these clinics in each province. Additional information can be found here.