Optimization of Prescriber Billing Tools - Health Insurance Status

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• Optimization of Prescriber Billing Tools - Health Insurance Status

As of December 19, 2024, changes will be made to prescriber billing tools in Connect Care so prescribers can quickly find whether a patient's care is supported by Alberta healthcare insurance, out-of-province insurance, private insurance, or no insurance. Health insurance coverage status information will be available to prescribers in a number of places, including patient lists, trackboards, and schedules, the patient chart sidebar, and also the Service Code Capture activity.

For more information, see:

• Manual: Professional Billing - Patient Health Insurance Status
• Tip: Patient Health Insurance (Coverage) Status
• Demo: Health Insurance Coverage and Charge Capture

RAAPID Intake Encounter Charge Filing

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• RAAPID Intake Encounter Charge Filing

Charges dropped in Intake encounters (used in the RAAPID workflow) will now file automatically upon acceptance by the clinician, with no change to the RAAPID workflow. 

When these charges are accepted, clinicians will immediately see the status change to "Filed". Any charges entered in error can still be removed after filing.

• Manual: RAAPID Workflows and Intake Encounters
• FAQ: Finding Intake Encounters

WCB and Connect Care - Updates

Enhancement updates provide short alerts to new, fixed or improved Connect Care functions...

• WCB Form Submission and New Reports

As of October 19, 2021, a Workers' Compensation Board (WCB) form can be completed within Connect Care and submitted to WCB directly from Connect Care. 

The new WCB SmartForm replaces an existing WCB SmartLink available in the "Wrap-Up" tab for ambulatory charts (last section), and can be found in the "Dispo" tab for emergency charts. The "WCB Form" can be completed in steps, with a final validation step confirming presence of all required information as well as the type of submission (direct or via third party). 

Current and previously completed WCB forms, related to any ambulatory or emergency visit, can be viewed in Chart Review under the "Encounters" tab, and easily found by filtering for “WCB Visits”.

There are also two new WCB reports found in "Print Documents", as well as a third-party billing report in the reporting workbench.

For more information, new tip sheets are provided for ambulatory and emergency department contexts.

• Tip: WCB Documentation for Ambulatory Clinics
• Tip: WCB Documentation for ED
• Tip: WCB Billing Reports
• Manual: Charge Capture

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.

Why is the Service Code Capture showing stray Lab charges?

Problem: Many Wave 1 Connect Care prescribers have noticed stray (not related to professional billing) "charges" appearing in the Service Code Capture activity. It is not clear what these mean or if they will affect legitimate professional billing claims.

Solution: This configuration problem has been fixed with the December 12 system update. Please report any stray charges that appear after this date. Note that the prior charges had no impact on professional billings and required no action on the part of the prescriber.