Irrespective of whether a physician intends to submit claims via Connect Care (AHS) professional billing services or a third-party billing service, physicians can use Connect Care to capture and record the services provided. This section is about how service events ("charges") can be recorded using the desktop (Hyperspace) user interface.
Charge Capture - Hyperspace
A "Service Code Capture" activity is available in both inpatient and outpatient contexts. It assembles all the information needed to support a billing claim, including patient demographics, date of service, providers and linked encounters. This facilitates rapid entry of professional billing codes for visits, procedures and other interactions.
Billing workflows are simple and consistent for all prescriber services covered by Alberta Health. The following resources describe and demonstrate details:
Some attention is required when entering information for services that will be billed directly to the patient or to other jurisdictions (e.g., traveller insurance).
Workers' Compensation Board
For those who bill with Connect Care (real or shadow billings), dedicated WCB work queues are triggered by actions that billing physicians take within Connect Care. Claims for services performed as part of WCB assessments will not be satisfied unless the provider completes a number of required in-system activities.
Minimum requirements for a successful submission include:
Consultation letter (or emergency visit summary) completed in Connect Care following the usual workflow for an emergency or ambulatory care assessment and summative communication. The letter or summary must be signed on the patient chart.
Appropriate service code(s) entered using the Service Code Capture activity.
"WCB" entered to the "Additional Comments" section at the bottom of the charge composer for any service (billing) codes that are WCB-relevant. This is done in the Service Code Capture activity or in the "Service Codes" section of the outpatient visit "Wrap-Up" tab or the "Service Codes" section of the emergency encounter "Wrap-Up" activity. The WCB comment flags the claim for attention by a WCB Billing Analyst.
WCB form completed (either in "Wrap-Up" section of the emergency encounter or in "Progress Note" for an ambulatory encounter). This is embedded in the relevant charge capture event for emergency encounters, and is pulled into a progress notes for ambulatory, orders-only or documentation encounters. The ".WCBFORM" SmartPhrase is used to set up the form-driven report. Note that this form leaves a placeholder (block) in the note. Its contents are re-examined by selecting the "WCB Form" button at the top of the note.
It is important to complete these steps promptly, ideally on the day of the patient encounter. WCB specialist report fees degrade depending upon whether an assessment is received same-day, on-time or late.
WCB billing processes continue to be refined, with this section revised accordingly.