What Most Firms Won't Publish: Exactly What This Costs

Who is this for?

Anyone who isn't sure whether the firm can help. The Initial Assessment is the starting point for every engagement — a focused review of your situation, your documents, and your options. Whether you're a provider with a stack of denied claims, an employer staring at a Revenu Québec audit letter, or an individual whose carte d'assurance maladie application was returned, this is where clarity begins. It's also for people who've already tried navigating RAMQ on their own — spent hours on hold with the Régie, submitted forms that came back with cryptic rejection codes, or received conflicting advice from their accountant and their HR department. The assessment cuts through that noise.

What's included?

A 60-minute consultation with a named analyst — not a junior intake coordinator, not a chatbot, but one of the firm's senior RAMQ specialists who will be assigned to your file if the engagement continues. During the session, the analyst reviews your documentation: claim submission records, denial notices, RAMQ correspondence, employer contribution statements, eligibility letters, or whatever is relevant to your specific situation. Following the consultation, you receive a written assessment summarizing the problem, the firm's recommended approach, applicable RAMQ procedures and timelines, and a fee estimate for the full engagement. You'll see every line item before deciding to proceed.

The assessment is designed as a standalone deliverable — you walk away with a written analysis of your situation regardless of whether you continue. Many clients use this document with their own accountants, legal counsel, or boards to make informed decisions. The written assessment typically runs 4–8 pages depending on complexity, and is delivered within 5 business days of your consultation.

Important: If the firm proceeds to a full engagement, the $750 assessment fee is credited against the total — you don't pay it twice. This applies to every engagement tier below, whether contingency, project-based, or retainer.

Who is this for?

Healthcare providers with denied or unprocessed RAMQ claims — whether 5 claims or 500. Physicians billing out-of-province, physiotherapy clinics with rejected fee-for-service submissions, diagnostic labs whose claims were flagged by the Direction du contrôle du paiement — if RAMQ owes you money and you haven't been able to collect, this is the engagement structure built for your situation. The fee structure is tied to the amount recovered, not billable hours. If the firm doesn't get your money back, you don't pay a percentage fee. That alignment of incentives is deliberate — the firm puts its revenue at risk alongside the client's. You can see real recovery outcomes on the firm's case studies page, including a Mississauga physiotherapy network that recovered $141,000 in denied claims.

What's included?

Complete claim audit — the firm reviews every denied or unpaid claim line by line, identifies the specific rejection codes (whether it's code 50 for invalid health insurance number, code 62 for service not covered, or any of the dozens of RAMQ processing codes that providers encounter), and determines the corrective action for each. This includes correction of claim data, resubmission through proper channels, and persistent follow-through with RAMQ until payment is released. If a demande de révision is required — which happens when RAMQ's initial decision needs to be formally contested — the firm prepares and files the complete submission, including supporting documentation and written arguments referencing applicable RAMQ administrative policies.

The firm handles all correspondence with RAMQ's regional offices and the Direction du contrôle du paiement, so providers don't have to navigate hold queues, fax chains, or ambiguous form requirements. Monthly denial rate monitoring is included for the duration of the recovery engagement, so the same billing errors don't recur once the current claims are resolved. For a detailed breakdown of the claims recovery service, visit the services page.

Important: If the firm doesn't recover the money, the client's exposure is limited to the $750 assessment fee. No recovery, no percentage fee. The 18% is calculated on the net amount deposited into the client's account by RAMQ — not on amounts claimed, projected, or estimated. The firm's incentive is to maximize what actually lands in your account.

Who is this for?

Employers facing RGAM audits, organizations needing staff training on Quebec health insurance obligations, or providers requiring billing code optimization — engagements with a defined scope and timeline. If you're an Ontario employer with Quebec-resident employees and Revenu Québec has flagged your RGAM contributions, this is how the firm structures the engagement. If you're a clinic administrator who suspects your billing team is under-coding or miscoding RAMQ submissions, this is the path to a systematic review. Every project begins with a written scope letter, and no change orders happen without a conversation. You'll know exactly what you're paying for before the work starts.

What's included?

Scope varies by engagement. Common projects and their typical ranges:

• RGAM compliance audit: $4,500 – $8,500 — Covers a full review of employer contribution records, employee eligibility classification, cross-provincial workforce analysis, and a written remediation plan with specific action items and deadlines. Typical duration: 3–5 weeks.
• Billing code optimization: $3,200 – $6,800 — The firm reviews 6–12 months of claim submissions, identifies systematic under-coding or miscoding patterns, and delivers a corrected billing protocol document your team can implement immediately. Includes one training session with billing staff.
• Staff training workshops: $2,400 – $4,200 per session — Live bilingual sessions (English/French) for administrative teams, covering RAMQ billing procedures, common rejection code resolution, eligibility verification workflows, or RGAM employer obligations. Sessions are typically 3–4 hours and include printed reference materials.
• Regulatory monitoring subscription: $1,600 / quarter — The firm tracks RAMQ circulaires, fee schedule amendments, and policy changes relevant to your practice or organization, and delivers a plain-language quarterly briefing with specific action items for your operations.

Every engagement begins with a written scope letter — no change orders without a conversation. The firm doesn't bill for phone calls, emails, or internal research time. If the scope changes mid-engagement — and occasionally RAMQ throws something unexpected into the mix, like a mid-project policy amendment or an audit notice that changes the priority stack — the firm flags it and gets written approval before proceeding. The scope letter is a contract, not a suggestion. Visit the services page for detailed descriptions of each service offering.

Who is this for?

Clinic networks, staffing firms, and multi-province employers with recurring RAMQ exposure who need continuous access to the firm's expertise. If your organization interacts with RAMQ weekly — or even daily — the retainer model replaces ad-hoc engagements with a single, predictable monthly fee and a named analyst who knows your files as well as you do. This structure is particularly valuable for organizations managing seasonal workforce fluctuations between Ontario and Quebec, staffing agencies placing healthcare professionals across provincial boundaries, or multi-location clinic groups that process hundreds of RAMQ claims monthly and need someone monitoring denial patterns in real time.

What's included?

Named analyst on call — the same person, every time, who already knows your file history, your organizational structure, and your specific RAMQ pain points. Priority response — same business day, guaranteed, for any inquiry or escalation. Monthly claim monitoring that tracks submission volumes, denial rates, rejection code patterns, and processing timelines so problems are caught before they compound. Quarterly regulatory briefings summarizing RAMQ circulaires and fee schedule amendments, translated into plain-language action items specific to your operations. Unlimited phone and email consultations — no per-call charges, no "quick question" invoices. An annual compliance audit included at no additional charge, covering RGAM obligations, billing accuracy, and eligibility verification protocols.

The retainer also covers resource allocation models and risk register maintenance for clients managing cross-provincial workforces — particularly relevant for employers who need to track which employees trigger RGAM contribution obligations as they move between Ontario and Quebec assignments throughout the year. Read what retainer clients say about the firm's responsiveness on the testimonials page.

Important: The retainer commitment is 12 months, billed monthly. If your needs change significantly mid-term — for example, if an acquisition doubles your headcount or a divestiture eliminates your Quebec exposure — the firm will work with you to adjust the arrangement. The goal is a long-term relationship, not a rigid contract that no longer fits.