There are signs of progress in the bitter dispute between Nova Scotia doctors and the Department of Health and Wellness over how doctors are audited.

CBC News has a copy of the report commissioned to try and end the dispute, which is over $700 million in fees paid to doctors.

The current method of tracking claims largely relies on the honour system.

The dispute began in 2011 when the health department ordered a manual assessment before it would pay claims for multiple services for the same patient on the same day. The process is called stacking.

The audit automatically targeted specialists in fields like plastic and vascular surgery, OBGYNs and ophthalmologists.

The increased rate of audits cost doctors time and money, and doctors also had no appeal process to the pre-payment assessment.

“It would mean a request for more information, partial payment or a delay in payment, or potentially no payment at all,” said Kevin Chapman of Doctors Nova Scotia. “It really bogged the system down.”

Deep distrust

The audit practices under dispute were sent to accountant John Carter, who wrote a 32-page report that the CBC obtained Monday. His report found a deep distrust between the two sides.

“Many physicians do not believe that [the Department of Health] is acting in good faith,” he wrote. “The [department] believes many physicians routinely bill without regard to the provisions of the Physicians Manual.”

Carter said it wasn’t clear if the auditing was even working. “There are no statistics to indicate whether the ‘stacking initiative’ is identifying over-billings proportionate to the effort being expended,” he wrote.

Chapman said a fair, open, transparent system would improve trust between the two sides.

“We’re doing a review of the data right now and we will review them with Doctors Nova Scotia when we have them to figure out how to move forward,” said Angela Purcell of the Department of Health and Wellness

The report makes 18 recommendations, which both sides say they’re trying to implement.