MedPros Insider, Issue 10: Four months, two weeks early (and a lot to be thankful for)

MedPros Insider · October 2026 · Issue 10 · 4-min read

A Thanksgiving thank-you, the Afiya clinic we finished two weeks early, two FHO+ ratios to check, and what’s new for pharmacies and primary care.

A lot to be thankful for

MedPros Insider is a short note from me, once a month, for the doctors, pharmacy owners and healthcare investors we work with: what we’re seeing, what’s changing, and what we’re building.

This Thanksgiving, I want to say something I don’t say often enough: thank you.

To our clients, for trusting us with your clinics, billing, launches, construction and more! To the doctors and pharmacists who keep showing up for patients, even in the hard weeks. And to our own team, on site, on the phones and behind the screens, who make the work look easy.

You’ll see that below. Afiya trusted us with their third clinic, and our crew handed it over two weeks early. That doesn’t happen without a lot of people pulling in the same direction.

And a special thank-you to our MedPros operations and management team. We went bowling to celebrate, a small way of saying thanks for everything you carry, from billing to launches to job sites. You’re the reason this newsletter has so much to share.

So here’s my ask for the long weekend, and it’s our One Rule: say thank you while people can still hear it. Pick one person and tell them. A call is enough.

Happy Thanksgiving.

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What We’re Seeing

FHO+ pays now. The 25% / 5% check comes later.

Six months in, here’s what I’d tell a colleague over coffee: getting paid for your hours doesn’t mean everything was billed right.

In Year 1 (April 1, 2026 to March 31, 2027), OHIP’s system checks only two caps: 14 hours a day, and 240 hours per 28 days, prorated by month. It doesn’t yet apply the 25% / 5% limits on indirect care and clinical admin before it pays you.

Go over either ratio and you still get paid. The Ministry recovers the extra later.

What our billing team keeps seeing: physicians logging hours but skipping the daily activity note for indirect care and clinical admin, or not checking the 25% / 5% ratios until the month is almost over.

Those are two different risks. Going over a ratio gets paid now and taken back later. A missing activity note leaves your hours with nothing behind them if the Ministry asks to see your records.

What I’d do

• Every day, jot down your hours by type, plus a short list of what you did for indirect care and clinical admin (e.g., “charting, lab results, referrals”). No per-patient detail or start/stop times needed.
• Check your two ratios during the month, not just at the end: indirect care plus clinical admin at no more than 25% of your total hours, and clinical admin at no more than 5% of your direct plus indirect hours.
• Compare what you billed with what OHIP actually paid, so rejected or adjusted claims don’t slip by.

Want a second set of eyes? Email me with the subject REVIEW. Our billing lead and I will take a complimentary 15-minute look and get back to you within two business days.

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The Brief: pharmacy and primary care

PHARMACY · DOCTORS

Pandemic-era controlled-substance powers are now permanent

As of October 1, pharmacists’ pandemic-era powers on controlled-substance prescriptions are permanent. Pharmacists can take verbal prescriptions from a practitioner, and transfer or renew them within two years of the day the pharmacy first received them. Ontario’s renewal limits still apply.

What it means: That two-year clock starts the day the pharmacy first gets the prescription, so make sure that date is on file. Taking a transfer? Record the date the first pharmacy received it.

FAMILY DOCTORS

New funding for primary care teams

Ontario is funding new and expanded primary care teams to connect 600,000 more people to a family doctor or team. Unless a proposal is Indigenous-led, it goes through your local Ontario Health Team and Primary Care Network.

What it means: If you’re in an FHO or FHN, or an FHG group ready to become an FHO, this is a chance to form or grow a Family Health Team, adding nurses and other health professionals as you take on more patients. Proposals are due 5 p.m. ET on November 20, so talk to your OHT and Primary Care Network now.

By the numbers

• 20+
  Clinics across Southern Ontario we support with management and billing.
• 265.7
  The most FHO+ hours you can bill this October (31 days).
• 600,000
  More Ontarians the new primary care team funding aims to connect to care.

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Ask Naz

Q: We’re six months into FHO+. Do I really need a daily activity list for indirect care, or are the hour totals enough?

A: Hour totals alone aren’t enough. For indirect care and clinical admin, you need a short daily list of what you did: charting, reviewing labs, referrals, that kind of thing.

No per-patient breakdown, no start/stop times. A line or two a day is fine.

Nobody asks for it when you bill, so you can still get paid without it. But if the Ministry asks to see your records later, that note is what backs up your hours.

Email me with the subject TRACKER and I’ll send you our one-page template.

Got a question of your own? Send it to me. I never use names.

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This month’s highlight · From the MedPros floor

Afiya’s third clinic: a four-month build, finished two weeks early

In September, Afiya Pain Clinic opened their third location, in Scarborough, in partnership with Scarborough Health Network. Our construction team built it.

It’s an OHP Level 2 clinic. That’s the CPSO’s category for Out-of-Hospital Premises that do procedures under IV sedation or with major nerve blocks. The College approves and inspects the space, down to the procedure and recovery rooms, ventilation and backup power.

We had four months to build it. We handed it over two weeks early. On a build where every room has to meet the College’s standards, that doesn’t happen by accident.

Then we got to celebrate at the grand opening. Seeing a space go from plans to a working clinic never gets old.

Thank you, Afiya team, for trusting us with your third clinic.

And to our crew: two weeks early on a build like this is your work. Thank you.

What else is happening

We support over 20 clinics across Southern Ontario, helping doctors and groups get great results in both management and billing. Also on the go:

• North York: we secured a 4,800 sq ft location for Dr. Clarke’s new physician-led clinic: walk-in and family practice, specialist services, an on-site compounding pharmacy and a dental clinic. Thanks to Dr. Clarke and our real estate partners at Nest Seekers for landing a highly sought-after spot. Construction starts shortly; opening planned for spring 2027.

• Oshawa: we’re helping a long-time client, an FHO and urgent care group we’ve worked with on several projects, expand into a 15,000 sq ft, three-floor medical building: family practice, urgent care and cardiology.
• Next: more on the way in London, Peterborough and Oshawa.

Thinking about opening, buying, selling or building a clinic? Just email me. It comes straight to me.

Email Naz

Talk soon,

Naz Aziz
President, MedPros
416.479.0077 · naz@medpros.ca · medpros.ca

P.S. OntarioMD has a free FHO+ hours calculator. We put together a one-page tracker that goes a step further: the 25% and 5% ratios plus a daily activity-note template. Email me with the subject TRACKER and I’ll send it over.

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General information only, not legal, tax or accounting advice.