Provincial Health FAQ's

Mary Jane -

Features within claims vary depending on the Province where you are located.

"Some" Provinces may see a section within the claim to Bill a Patient. 

Frequently Asked Questions

How does a clinic get set up for the first time using Provincial billing (this applies to all clinics)

If you have an existing system we recommend starting with a new Provincial billing number. If you have more than 1 Global Office System you will need separate billing numbers for each system.


Where do payments from the Province get deposited?

Speak with Provincial Health for details.


How does a clinic get paid when there are 2 clinics?

Contact a Provincial Health representative for details.


Why is the amount paid by the Province not the amount billed through the Tariff?

The Province may not pay the amount the clinic billed. Open the claim to see what tariff code was given to the claim. Provinces do update billable amounts. They may have changed the tariff code and paid less than you expected.

The clinic will receive a payment if you are over paid or under paid.


How to fix claims that are over or under paid

1. Over paid claims

If a claim is over paid, create a manual payment for the difference and create a payment type as write off to get rid of it.


2. Under paid claims

If a claim is under paid create a claim for the difference.


When would I use a Manual payment?

1. If Provincial health has sent a payment but not sent a notification.

2. When a claim is rejected but they pay it any way.

3. If the clinic forgets to download a remittance file and the file is no longer available. You can manually add the payment.


When would I use the Debit request?

1. If the Clinic makes a mistake on a claim.

2. The Province paid in error. Submit a Debit Request because Clinic owes "Teleplan" back. This is for BC.


Can I void a claim?

If you have not submitted a claim you can void it.

We strongly suggest you do NOT void a claim if you have already included it in a submission. It's best you wait for a claim to be rejected.

After a rejection a claim remains rejected. You can Void a rejected claim in order to remove it, for example, if you want to bill it to the patient instead.

You can fix a rejected claim and resubmit it. You can also void a rejected claim and manually create the new one if necessary.


How do I fix appointment claims with Errors?

Go to: Accounting>Appointment Claims.

Claims with errors will have a Yellow Error Icon located to the left of the item.

When a claim has errors you will not see “Create Claim” on the drop-down menu options until the error is fixed.


Yellow Error Icon

There may be missing information within a patients profile that will prevent you from creating a claim.

  • Profiles with errors are identified with a yellow icon to the left of the entry.
  • Hover over the icon, a pop up will identify what is missing before you can proceed.
  • Go to the Patients Profile and input missing information.


Below is an image of the yellow error icon.

Provincial billing yellow error icon.JPG


Pay Selected Claims

Select “Pay Selected Claims” from below the “Actions” heading located in the top right hand corner of the page.


Can I delete a submission file?

The submissions files under the Documents tab in Global should NOT be deleted. Deleting a file does NOT delete it from the Province's system. Wait until the claims have been paid/rejected etc.

If you need to delete a submission that has not been uploaded through the provincial billing portal, go to Accounting and select the Claims Submission option.

 

Have more questions? Submit a request

0 Comments

Please sign in to leave a comment.
Powered by Zendesk