Why are Professional Billing claims delayed?

Problem: Physicians using full Connect Care professional billing services may have noticed delays in reimbursement from Alberta Health during December 2019. Those in alternate reimbursement plans (including AMHSP) will have noticed less, as their "shadow" billings do not immediately impact personal reimbursements. Nonetheless, delays are a worry. What happened?

Solution: While it is true that 1) professional billing volumes may have been temporarily reduced by productivity impacts of launch activities, 2) physicians learning a new system may not record charges with all requisite information, and 3) the naming of some billing codes needed revision... these understandable transition challenges were not the primary cause of December payment delays.

Alberta Health (primary source of payments) experienced an unplanned downtime of its professional payment system, resulting in delays to payments that were not related to the Connect Care system.

All Connect Care factors steadily improve, claims acceptance rates have returned to pre-launch norms for most physicians, and the AH downtime is over.

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