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, Workman 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 - where 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 - where 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 - where 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, and how to self-register for option 2, is available in short summaries and an online resource.

Manual Sections

Billing Codes

More Information

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