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Provincial (Medicare) billing (PEI)
Reviewing and submitting provincial (Medicare) bills to Health PEI
Reviewing and submitting provincial (Medicare) bills to Health PEI
Updated over a week ago

When you create bills in the CHR, they are either saved as Draft or Ready to submit status, depending on the default billing status for your CHR account. See Changing the default billing status for your account.

If your default status is Draft, you must manually change the status to Ready To Submit so that the bills can be submitted to Health PEI daily at 6pm.

📌 Note: You can modify your bill before it gets submitted to Health PEI, i.e. when the bill is in Draft and Ready to Submit status.

⚠️ Important: Once a claim has a status of Submitted, you can't make changes to it, until you receive a response back.

Steps (to manually submit bills to Health PEI):

📌 Note: You can manually submit an insured bill to Health PEI from Visits, the Billing dashboard, encounters (saved or signed) and the Insured billing section of patient charts. If you have many bills to submit, we recommend you use the Billing dashboard.

  1. From the main menu, click Billing.

  2. To see all claims with status Draft, filter the Billing dashboard by:

    • Status: Draft

    • Insurer: Health PEI

    • Applicable Service Date

    • Billing Practitioner(s)

    • Location(s)

    A billing report appears.

  3. Click on a bill.
    The Edit Insured Payment window appears.

    📌 Note: You can modify the bill if required. See Adding and modifying billing items (service codes) to your provincial bills.

  4. Click in the Status field and select Ready to Submit from the list.

  5. Click Save.

    📌 Note: The bill's status remains Ready to Submit until 6pm when the bill is sent to Health PEI and the status changes to Submitted.

  6. To view where in the submission process the claim is (transactions going out and coming in), open the claim and click the information icon at the top-right corner of the billing item field. A Transaction Details window appears.

    📌 Note: If the claim cannot be submitted, the status changes to Attention Required and the individual billing 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 Health PEI.

Created: January 7, 2022

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