⚠️ Important: If you work in Ontario, you must have a MDBilling account set up to bill in the CHR. See Integrating your CHR account with MDBilling.

If you are a provider, the standard and most efficient way to create bills is from within an encounter that is associated to an appointment.

To make your workflow even more efficient, you can add billing items to encounter templates if you use the same billing codes for routine visits and/or presenting issues. See Adding billing items to encounter templates.

Steps

1. Start an encounter associated to an appointment. See Other appointment actions.

2. If applicable, select an encounter template (with or without billing items added). See Starting an encounter.

3. In the Billing Items section of the encounter, complete or change the Insured Payment Detail and Ontario Health Insurance Plan Payment Detail fields, as necessary. For more information, see Creating provincial bills.

a) Template: Ensure Ontario Health Insurance Plan (OHIP) is selected for OHIP bills.

b) Billing Practitioner: If you are a provider, by default your name is displayed. If you are not a provider, you must select a billing practitioner. Click No Provider Selected, and then click No Provider Selected again in the window that appears. Search for the appropriate provider. Under Available Billing Provider, select MD Billing.

⚠️ Important: The billing practitioner must be connected to MDBilling in order to submit bills. Do not create any bills within the CHR until your contact at TELUS Health informs you that the MDBilling integration is complete.

c) Location: if you have more than one location, select the location where the patient was seen from the list.

d) MOH Group: Click MOH Group to enter or change the group number for this bill, if necessary.

e) Referring Physician Billing Number: If there is a Referring Practitioner specified in the patient's demographics, their billing number appears here. If there is no referring provider specified and the bill requires one, either type the referring provider's billing number or click the magnifying glass icon to search for the provider in your list of contacts.

f) Service Location: if you are required to submit SLI codes, select an SLI code from the list. ⚠️ Important: If you are using SLI codes, you must enable a setting in your MDBilling portal. See Enabling Service Location Indicator codes for more information.

g) WSIB: If the bill is to be paid by the MOH but is WSIB-related (such as minor assessment because of work injury), click WSIB and select Yes.

4. Add the service codes to the bill. If you selected a template with insured billing items added, the billing items are displayed. Click a billing item to modify or delete it.

💡 Tip: You can clone past insured billing items by clicking the clock icon next to Insured Billing and selecting the billing item you want to use.

Click Insured Billing to add a new service code. An Edit Billing Item window appears.

5. Complete the applicable fields:

Field

Description

Code / Description

  1. If you want to search by code, start typing the code in the first search box.

  2. If you want to search by description, start typing the description in the second search box.

  3. Matched are displayed, select one from the list.

💡 Tip: Select the star icon next to the specific code to save the code to your favourites. Every time you create a bill, the starred favourites appear first in the list.

Base Amount

The fee amount of the code you selected is automatically populated.

📌 Note: The amount can be manually changed if applicable.

Quantity

If the code requires time units or number of services, such as codes for surgery, type the number of units or click the up or down arrow.

Diagnosis Codes

If you added a diagnosis code in the Assessment section of the encounter, it is pre-populated for you.

Otherwise, enter the diagnosis code, or start typing a description to search for and select a diagnosis code from the list.

💡 Tip: Select the star icon next to the specific diagnostic code to save it to your favourites. Every time you create a bill, the starred favourites appear first in the list.

📌 Note: The list of diagnosis codes available depends on what is selected as your Default Diagnosis Template in Settings > Templates. See Configuring diagnostic codes for your account.

Service Date and Time

If you are logged in as a billing provider and the patient had a recent (past) appointment booked in your schedule, the date defaults to the appointment date.

If you are not a billing provider, the date defaults to the Visit Date specified at the top of the encounter.

To change the date and time for the specific billing item, click the calendar and clock icons.

This is useful when you see a hospital patient daily and you want to create multiple billing items with different dates under one claim.

6. To save your changes, click outside the Edit Billing Item window when you are finished adding the service code.

7. Click Insured Billing to add additional service codes.

8. Click the billing item to edit or delete it.

9. Sign your encounter.

If your default billing status is Ready to Submit and there are no errors with the bill, the claim is submitted to MDBilling and the claim status updates to Submitted.

If there is any missing information in your bill (such as a diagnosis or a billing practitioner), or the patient's health card number is invalid, and your default billing status is:

  • Draft - an error appears and the encounter is not signed. Fix the issue and attempt to sign the encounter again.

  • Ready to Submit - the encounter is signed but the bill is not submitted to MDBilling. The status of the claim is Attention Required and the individual bill items have a status of Invalid. Fix the issue. Once there are no errors, change the claim status back to Ready to Submit so the claim can be submitted to MDBilling.

📌 Note: The billing items do not appear in the Insured Billing for this patient or the Billing dashboard until you sign the encounter.

Updated November 25, 2021

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