Reconciling provincial claims (PEI)

You can manage and reconcile your claims that have been processed by Health PEI from the Billing dashboard.

Here, you can filter your clinic's list of bills to display:

Attention Required bills (bills that are rejected, partially paid or are flagged by the CHR with errors)
Submitted bills that were sent a while back and not yet received a response from Health PEI
Held bills
Completed bills (bills that are paid in full)

From this list, you can edit and resubmit a bill or update a bill's status.

📌 Note: You can export billing reports or billing data from the Billing dashboard for reporting purposes or to transfer the data into another application. See Exporting billing reports from the Billing dashboard

Steps:

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

2. Filter the list to display the bills you want to view or manage: At the top of the window, click the white panel.

3. Using the following table, set the filters and click Apply.

To view or manage...	Apply the following filters
Refused (rejected) claims, partially paid and claims flagged with errors by the CHR	Status: Attention Required and Cancelled (when multiple billing items in a claim have different statuses, i.e. one item paid, another refused, the status is Action Required. When all billing items in a claim are refused, the status is Cancelled) Insurer: Health PEI Date: Set the service date range you want to view bills for Billing Practitioner(s): Select the providers you want to view bills for Location(s): If your clinic has multiple clinic locations, select the locations you want to view bills for See Managing refused claims.
Unpaid claims	Status: Cancelled Insurer: Health PEI Service Date: Set the date range you want to view bills for Billing Practitioner(s): Select the providers you want to view bills for Location(s): If your clinic has multiple clinic locations, select the locations you want to view bills for 📌 Note: If you want to dispute a claim, see Submitting appeals to Medicare (PEI) for more information.
Submitted claims (claims that have not yet received a response from Health PEI)	Status: Submitted Insurer: Health PEI Service Date: Set the date range you want to view bills for Billing Practitioner(s): Select the providers you want to view bills for Location(s): If your clinic has multiple clinic locations, select the locations you want to view bills for ⚠️ Important: Make sure no bills have a status of Submitted for longer than 90 days.
Held claims	Status: Held Insurer: Health PEI Service Date: Set the date range you want to view bills for Billing Practitioner(s): Select the providers you want to view bills for Location(s): If your clinic has multiple clinic locations, select the locations you want to view bills for ⚠️ Important: Make sure no bills have a status of Held for longer than 90 days.
All paid claims	Status: Completed Insurer: Health PEI Service Date: Set the date range you want to view bills for 💡 Tip: To search by the claims' paid date, in the Search By drop-down, select Paid Date. Billing Practitioner(s): Select the providers you want to view bills for Location(s): If your clinic has multiple clinic locations, select the locations you want to view bills for

💡 Tip: To see transaction details of claims submitted to Health PEI and claims returned from Health PEI, click a bill and at the top-right corner of every billing item, click the information icon. This is particularly useful when you want to see when you were paid. For example, to see the history of changes made to a bill, for example to see that the bill was sent, it came back refused, changes were made to the bill and resubmitted, and then you got paid. See Viewing transaction details in submitted claims.

Updated January 18, 2022