Alberta Medical Billing Software

Billing Alberta Health Has Never Been Easier

Join the thousands of other Alberta Physicians using ClinicAid

I choose ClinicAid because I can bill from anywhere that I can get the internet. The service is fantastic.

Terry Gerber - Billing Specialist
ClinicAid is very stable, very dependable and a joy to work with. The staff are very helpful. I would highly recommend it.

Dr. John Murphy - Physician, General Practice
Your service is far superior to what we have been receiving from past providers and the level of support I have been receiving has been A++.

Dr. Mohamed Nouh - Physician, Psychiatry
The flexibility of being able to do my own billing from any computer along with the excellent customer service is what continues to sell me on using ClinicAid.

Dr. James Watson Physician - Obstetrics & Gynecology
Adopting ClinicAid into our practice is one of the best business decisions we’ve ever made.

Dr. John Fernandes - Physician, Family Medicine
With ClinicAid I can do the day’s billing in less time than it would take to prepare and submit to a billing agent.

Dr. Jeffrey Mellor - Physician, Internal Medicine
ClinicAid is the most amazing medical billing software I’ve ever used. As a medical billing agent I’ve used every software out there and ClinicAid blows them all away with its slick design and helpful validations. ClinicAid literally saves me hours every month on my submissions, rejection handling and reconcilliation.I’m so happy I made the switch to ClinicAid and would highly recommend to everyone doing medical billing that they should give it a try.

Brenda-Lee Ryan - Billing Agent

Why ClinicAid is the only choice for Alberta Doctors

Intelligent billing shortcuts and tools. Submit a week’s worth of invoices in seconds.

ClinicAid AHCIP billing software helps you stay on top of accurate claims submissions by providing intuitive healthcare billing shortcuts and tools. You can submit the maximum number of invoices that AHCIP allows in weekly batches and be confident of:

The correct patient healthcare numbers and modifiers
Accurate code usage
Patient time recording

Our Alberta health billing software eliminates the time spent on manual entry and data accuracy rechecks, so you’re spending only seconds submitting accurate claims. That gives you more time to treat patients while ensuring you get all the money you’re due for delivering the best care possible.

Smart billing logic to cut down initial entry errors, superior rejection handling

Even the most experienced physicians and practices have a tough time keeping up with the many AHCIP restrictions on how they can bill medical codes. That’s why it’s more than just peace of mind to have the medical billing software in Alberta that delivers smart billing logic for accurate claims.

ClinicAid AHCIP billing software gives you the support you need to eliminate entry errors that can lead to claims rejections and lost or delayed income. When the occasional claims rejection happens, our Alberta health billing software delivers the automated support to help you:

Identify individual claim errors
Correct the problem
Resubmit for payment in the shortest amount of time with the least amount of effort and headache

Instant service code and dx code search fields with current updated SOMB

Alberta Health Care recently updated the Schedule of Medical Benefits (SOMB) (fee schedule and list of medical benefits insured under the Alberta Health Care Insurance Plan). You can avoid the data input nightmare if your practice is still using manual data entry or Alberta health billing software that doesn’t have the updated code search fields.

With ClinicAid medical billing software, Alberta physicians and practices can rest assured that they have the most up-to-date service code and DX code search fields to quickly identify and input the right code for the right procedure and patient every time. Spending additional time on billing code searches and input doesn’t guarantee that you’ll find and correctly input the right code. ClinicAid constantly updates our cloud-based Alberta Health billing software with the latest tools and data that follows the latest ACHIP SOMB, now and in the future.

Full referral provider Billing Number search fields as provided by Alberta Health

If you’re a consulting physician or specialist, AHCIP demands that you show the referring physician on the claim or face claim rejection. ClinicAid takes the uncertainty out of the process by providing referral provider billing number search fields as provided by Alberta Health. This gives you the top-of-mind reminder and the direction to ensure that you include the accurate referral provider billing numbers on every claim.

Submitting claims to AHCIP Alberta Health

OverView

What is H-Link?

H-Link connects clients (doctors, medical staff, and other health care professionals) to Alberta Health’s mainframe. Clients are able to send their billing and claim information electronically directly to Alberta Health for assessment.

Do I need to apply for access to H-Link myself?

While health care service providers, their staff, or service bureaus are able to access H-Link, you will not be required to set up your own H-Link access as it can be difficult and time-consuming.

ClinicAid customers designate our company as their “accredited submitter” as we have already gone through the approval process to connect with H-Link and are an Approved Submitter.

Medical claims submitted through ClinicAid

ClinicAid has the capability to complete any kind of claim that will ultimately be electronically processed at Alberta Health.

Most care providers will submit Fee For Service (FFS) claims that fall under the regular Schedule of Medical Benefits (SOMB), however, we also provide for ARP/APP (Alternative Payment Plan), as well as any podiatry, podiatric surgery, optometry, or oral and maxillofacial surgery practitioner which fall under the Allied Health Services Schedule of Benefits.

Any Out-Of-Province patients can also be billed to Alberta Health through the reciprocal billing agreement with all other provinces excluding Quebec. Quebec patients will need to be invoiced directly which can be facilitated through ClinicAid’s Private Billing feature.

How the Alberta medical billing cycle works

Alberta Health completes a billing cycle every week. Cut-offs, processing, and payments are all done within a week’s time, with payments being made for the previous week’s claims.

The general rules for submission cut-offs, processing, and payments for Alberta’s physicians and medical professionals are as follows:

Claims should be submitted before Thursday at 12:00 p.m. MST. Claims received after 12:00 p.m., but before the end of the business day, are often also accepted.
Claims submitted by the Thursday cut-off will be processed over the weekend and remittance files will be received by Sunday evening at the latest.
Payment of approved claims is made during the following week, usually, 7 days after the assessment of claims has been received.

Getting Set-up

Getting Started

Getting set-up for medical billing in Alberta is very simple with ClinicAid. We would suggest that you sign-up for your free ClinicAid trial and then do one of the following depending on your status as a health care provider.

If you are a new physician you will need to fill out form AHC11234 to set up a new practitioner ID which will be your permanent identifier with Alberta Health

If you already have a Practitioner number but would like to submit your bills using ClinicAid you will need to fill out form AHC11236 to request a new business arrangement number.

To complete the form, you would need to select registration type “Business Arrangement Request”, complete the provided fields, then select the “assign a new BA” checkbox and then select the appropriate billing tyle (fee for service, ARP, etc).

The Effective Date will be the date your BA is effective from. eg. If you have a backlog of month old invoices, you would need to backdate your effective date far enough to cover those old service dates.

Finally, you would complete the Practitioner Authorization section and send the form to us, including a void cheque so Alberta Health can set up your Direct Deposit info. We will complete the Accredited Submitter Certification section and forward to Alberta Health if your void cheque has been provided.

All of these forms can be faxed to the Professional and Facility Management unit for Alberta Health and Wellness at 780-422-3552. If you need assistance completing these forms you can call 780-422-1522 and speak to an AHW representation or you can always get in touch with us.
Note: During the pandemic, Alberta Health is not accepting fax or phone calls, the forms can be emailed to health.pracforms@gov.ab.ca

Shadow Billing / ARP

Some practitioners working in Alberta engage in an ARP or Alternate Relationship Plan where they are compensated using an Alternate method but are still required to submit their claims through H-Link. Sometimes this is called “Shadow Billing” as these claims are generally come back paid at zero or not paid as the physician is being compensated through the ARP group or organization rather than directly from the Ministry.

Submitting Shadow Billing claims through ClinicAid is very simple and physicians can manage both their Shadow Billing and their normal FFS for Fee For Service claims all in one ClinicAid account with multiple provider records and our ARP flag.
All ARP invoices are submitted with a TM modifier to track the time spent with each patient, ClinicAid will provide a count of your TM units on each remittance for your reference.

There is no additional charge or fees for doing Shadow Billing or using multiple BAs in 1 ClinicAid account.

If you have any questions on Shadow Billing or ARP billings please drop us a line!

FAQ

How do I move to ClinicAid from another program in Alberta?

Moving to ClinicAid from another software is quite simple in Alberta. You will only need to have a Business Arrangement number that’s connected to our “CPI” approved submitter prefix. Business Arrangements generally should not be transferred from one submitter to another so all you need to do is get set up with a new business arrangement number and start billing in ClinicAid whenever you are ready and you can continue settling your claims in your old software until they are all complete.

To make your transition to ClinicAid even better we can import your patient demographic data into your ClinicAid account free of charge if you can export that data into an excel, csv (comma separated values), or another spreadsheet format.

What is the effective date on my Business Arrangement?

The effective date on your BA should be back-dated far enough to encompass any old service dates that you still need to submit. It DOES NOT need to coincide with your start date on ClinicAid.

For example, if you had your BA effective date set for today, you would not be able to submit invoices with last month’s service date using your ClinicAid BA. They would reject with error 37 – invalid BA number.

You can backdate your effective date as far as you need, however, Alberta only allows 90 days for the first submission of invoices.

Can I edit an invoice after it's been sent to Alberta Health?

If you’ve sent an invoice, you will need to wait until ClinicAid receives a response on that invoice before you will be able to edit and resubmit. This will generally happen after the next weekly billing cycle.

It is not recommended to send a second bill if you realize you have made an error as Alberta Health will likely see the second invoice as a duplicate and it will be automatically rejected.

If you do submit a duplicate invoice, it can just be ‘settled’ to remove it from your Requires Action queue.

How often are referral providers updated in ClinicAid for Alberta?

Alberta Health generally sends us updates to the referral providers list twice per year and we update ClinicAid when we receive these updates. If you would like to check when the next update will be please feel free to submit a support request. If you would like us to add a provider to our list we can do that manually at any time.

When creating bills in ClinicAid you can also add any referring practitioner ID to a patient record or to a bill regardless of whether that practitioner exists in ClinicAid and you can also add your own referring practitioners in Admin→Referral Providers

ClinicAid Alberta After-Hours Billing quick reference guide

New Resource: AHCIP After-Hours Billing Quick Reference Guide

After-hours codes are codes billed in addition to patient visits to account for physicians working after-hours and/or travelling to a different location to care for a patient.

We created this AHCIP After-Hours Billing quick reference guide to provide you with key information and best practices to ensure correct billing of after-hours fee codes and modifiers in Alberta.

This guide will help you with:

Identifying the most common after-hours fee codes and when to bill them.
Correctly billing the after-hours time premium 03.01AA.
Understanding the different modifiers for after-hours billing.
Accurately billing the special callback fee codes.

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