Clinics located in Alberta can only submit medical claims to Alberta Health electronically. This is used by Doctors, Chiropractors, and Optometrists only.
The HLink module must be turned on. (Customer Support will enable this). Additional fields will be enabled on the Practitioner Profile and Clinic screen.
Clinic Information: Go to Settings>Clinics. Enter the HLink Facility #'s and HLink Functional Centre name. Save.
Practitioner # must be entered.
Practitioner types: Alberta health has their own Skill codes for each doctor. Select from the drop down option.
TIP: Practitioner Types/Codes that you do not find on the list can be added under Settings>Practitioner Types. You must use the Alberta Health Skill code exactly as they require.
How to create a claim
There are 2 ways to claim an appointment:
A. From the Accounting tab you can create a manual Claim.
B. From a patient’s appointment on the schedule.
A. How to create a manual Claim
1. Go to Accounting>New Claim. The New Claim screen will pop up.
2. The Invoice Date will default to the current day’s date. To change the invoice date (THIS IS NOT THE APPOINTMENT DATE), use the arrow keys and click on the calendar icon to open it and select an invoice date.
3. On the left side of the screen you will see Patient Name field. Type the patient's name or date of birth on the patient line and select the patient from the drop down list.
To add a new patient click the down arrow at the end of the Patient Name field. The Quick Patient creation input box will open.
Note: Alberta Health requires the information for the fields with an asterisk.
4. Adjust the date for a back dated appointment, and finally select a tariff (fee code) and press the Add button to add the tariff to the claim.
5. From the Appointment Details section, If your clinic has only one practitioner, the practitioner’s name will default.
TIP: Setting a default Doctor/Practitioner in a claim is only an option available in Administrator profiles. Open the administrator profile. On the Profile page, locate the Default Practitioner/Doctor field and select the Practitioner/Doctor as the default then Save.
If your clinic has more than one practitioner, select the correct Practitioner by typing in the name on the practitioner line.
6. Enter the Tariff/Service Code, select Go. The description will auto populate and the Modifier field will appear.
7. Enter the Modify code.
8. Select Add at the bottom of the claim. The description and total will move to the left side of the claim.
9. Review the claim to ensure everything is entered then select Save.
B. Create a Claim from a patients appointment on the schedule
Click within the patients appointment block on the schedule and select Claim Appointment. Information will populate to the claim screen.
The process is the same as manual claim.
Alberta Health Submission Creation
1. Log into Global Office and click on the Accounting tab.
2. Select the Generate Submission link.
3. Click Create Submission.
4. Press Print.
5. The submission file has been created and is stored under Documents tab.
6. Click the Documents tab.
7. You should see a file at the top of the documents section.
8. Click the blue icon to the left of the item and select Download.
9. Select Save File to save it to your computer then select OK.
Log into the Alberta Health portal and upload the submission file.
1. Set up a new third party company called WCB and MPIC.
2. Set up a WCB insurance record in the Patients Profile under their Insurance tab.
How to set up 3rd party insurance
Go to Settings>Third Party Companies>New Third Party Company. The insurance name will be WCB and MPIC. Enter the other address/contact details then Save.
How to set up insurance under the Patients profile
1. To set up WCB in the patients profile. Open the patient’s profile, select the Insurance tab, then "New Insurance".
2. Select WCB from the insurance company drop down list.
How to complete and invoice the patient’s appointment with WCB
1. When the patient’s appointment is completed, click the appointment block on the schedule and select Complete and Invoice.
2. Create individual invoices or for clinics with larger volume use the Batch Billing option under the Accounting tab.
1. Go to Accounting>Create Batch Invoices.
2. Fill in the details to create the batch in the pop up window. Select WCB as the third party.
3. Confirm you want to create the Batch.
4. Select the Print Options link to view the batch.
5. Below are the options after creating the batch. Click the blue menu to the left of the item. Make your selection.
6. Then select the Mark Batch as Printed. This indicates to you that you sent the file to WCB.
7. You will be able to view the submission batch by changing the Search option Status field to Printed then click Search.
8. You will see a list of print batches. Click the blue icon to the left of the item to view it.