Professional Billing

Many physicians track, record and "bill" for services rendered, even when employed by Alberta Health Services (AHS) or contracted through alternate reimbursement plans. The Connect Care clinical information system (CIS) supports claims capture, generation of billing reports, submission of claims and adjudication of any funder responses. This includes billings sent to Alberta Health, Workers' Compensation and private insurers.

There are three professional billing relationships that physicians can have with Connect Care, based upon how service claims are documented and how they are managed:

• 1. Independent Charge Capture & Independent Claims Management - Physicians track and record their charges outside of Connect Care and use a third-party billing service to submit claims and manage responses.

  2. Connect Care Charge Capture & Independent Claims Management - Physicians use CIS tools to capture information to support professional billing claims, generate a report or export of the data, then use a third-party billing service to submit claims and manage responses.

  3. Connect Care Charge Capture & Connect Care Claims Management - Physicians capture charges using CIS tools and rely on the CIS and AHS billing services to take care of claims submissions and response management.

Background

Further information about who qualifies for each of the three professional billing relationships is available in short summaries and an online resource.

• • Byte: Professional Billing Supports

  • Byte: Professional Charge Supports

  • Insite: Professional Billing

  • Questions: servicecodecapture@ahs.ca

Manual Sections

• • Charge Capture

  • Charge Capture Personalization

  • Mobile Charge Capture

  • Submitting Claims Outside of Connect Care

  • Submitting Claims Through Connect Care

Billing Codes

• • Tip: Virtual Care Billing Codes

  • Crib-Sheet: Pandemic Professional Billing Codes

  • AMA: Service Code Navigator

  • AMA: Virtual Care Fee Codes

More Information

Professional billing is the topic of one of the Connect Care Optimization Clinic themes, with updates to the prescriber update blogging channels:

• • Tips: Professional Billing

  • Questions: Professional Billing

  • Support: Professional Billing

  • Contact: servicecodecapture@ahs.ca