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Managing refused and invalid provincial (MSP) claims (British Columbia)
Managing refused and invalid provincial (MSP) claims (British Columbia)
Updated over a week ago

When you submit claims to MSP through Teleplan, Teleplan may auto-refuse some incorrect bills. These refusals appear in the CHR within a day. You may also receive additional claim refusals with your biweekly remittance, which appear in the CHR on the remittance date.

When MSP rejects a claim or when the CHR identifies an issue with a bill prior to submission, the CHR flags the associated bill as Attention Required. You manage attention required bills from the Billing dashboard. Here, you can filter the list of bills to display all Attention Required bills for one or more providers.

When you open an Attention Required bill, any rejected billing items (service codes) are flagged as either:

  • Refused (refused by MSP)

  • Invalid (flagged as invalid by the CHR - typically due to an invalid provincial health number or a missing diagnosis code)

The error or rejection reason(s) displays below the billing item as Error Messages or Messages.

You manage these bills by either:

  • Editing and resubmitting the bill

  • Editing the patient's provincial health number or demographics and resubmitting the bill

  • Changing the bill Status to Complete or

  • Changing the bill Status to Cancelled

Steps

1. From the main menu, click Billing. The Billing dashboard opens with a list of bills created today.

2. Filter the list of bills:

a) At the top of the window, click the white panel. The Current Filter window appears.

b) Set the following filter options, and then click Apply.

  • Status: Attention Required

  • Insurer: Medical Service Plan

  • Date: Set the service date range you want to view bills for (for example, the date 3 months prior to today - today's date)

  • Billing Practitioner(s): Select the providers you want to manage bills for

  • Location(s): If your clinic has multiple clinic locations, select the locations you want to manage bills for

A list of Attention bills display.

3. To open a bill, click its description.

💡 Tip: When you click the Patient column, the patient's chart opens instead of the bill.

4. Under each billing item flagged as Refused or Invalid, review the Messages describing the refusal or error reason.

💡 Tip: If you don't understand the reason for a refusal, contact MSP (1-866-456-6950).

5. Using the following table, manage the bill.

To do this...

Do this...

Edit and resubmit the bill

1. Edit the billing items or other bill details requiring modifications.

2. At the top of the bill, in the Status drop-down, select Ready to Submit.

Update the patient's provincial health number (or other demographic details) and resubmit the bill

1. From the bill, open the patients chart: Beside the patient's name, click the patient icon.

2. At the top of the patient dashboard, click Update Information, update the patient's information, and then click Save.

3. Return to the bill and click the patient's name.

4. At the top of the Patient Information pop-up, click the Update icon.

5. At the top of the bill, in the Status drop-down, select Ready to Submit.

Write-off the unpaid amount

At the top of the bill, in the Status drop-down, select Mark as Cancelled.

Accept the amount you received as "complete"

At the top of the bill, in the Status drop-down, select Mark as Completed.

Delete a bill that has not yet been submitted

You can delete an unsubmitted bill from the patient's chart:

1. From the bill, open the patients chart: Beside the patient's name, click the patient icon.

2. Click Start/Open > Insured Billing.

3. Beside the bill, click the Delete icon.

6. Click Save. The bill is updated or re-submitted.

💡 Tip: To view user actions, in the top-right corner of the Edit Insured Payment window, click Activity Logs. The user action, their name and the time they performed the action shows. To view more details such as status updates, click the details icon beside the action.

Updated August 12, 2024

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