Whether you're billing from an encounter, the Visits dashboard, or the Insured Billing area of the patient's chart, the process for adding billing items (service codes) to a bill is the same. From the Billing dashboard, you can also open bills and modify billing items as long as the bill's status allows you to edit the bill.

Steps

1. Start a bill from an encounter, from the Visits dashboard or from the patient's chart. If you're editing a bill, open the bill from the Billing dashboard.

2. Perform one of the following actions:

  • If you're billing from an encounter, at the top of the Billing Items area, click Insured Billing.

  • If you're billing from the Visits dashboard, click +Add Fee Item.

  • If you're billing from the Insured Billing section of the patient chart, click +Add Fee Item.

  • If you're modifying a billing item, click the billing item.

The Edit Alberta HLink Billing Item window opens.

3. Using the following table, complete the applicable fields.

Field

Description

Code / Description

1. To search for the service code:

  • by code, in the first search field, start typing the code.

  • by description, in the second search field, start typing the description.

2. In the list of matches, select the code you want.

💡 Tip: To set a service code as a favourite, in the list of matches, select the star icon beside the code. Every time you create a bill, starred favourites appear first in the Code/Description search list.

Base Amount

The fee amount for the code you selected is automatically populated. You can edit the amount if needed.

📌 Note: The amount in this field does not take into account the provider's specialty. Specialists can hover over the EQ icon that appears next to the field to view the true billed amount.

The correct amount is also displayed in the New Insured Payment window in the background.

Calls

Number of times the code is billed. Defaults to 1.

Modifiers

Explicit fee modifiers (up to 3) applied to the service.

The CHR uses the modifiers in conjunction with the fee code to determine the amount payable.

Only modifiers that can be used with the selected fee code are available in the list. For this reason, always enter the fee code before you select a modifier.

Units

Number of times the modifier is applied, if applicable.

Diagnosis Codes

Diagnosis codes recorded in the Assessment section of the encounter, may be pre-populated in the bill (if your billing settings are set to do so).

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

Another search field appears, prompting you to enter another diagnostic code. Enter another code or click inside the Edit Alberta HLink Billing Item window to exit the search field.

You can add up to 3 diagnosis codes.

💡 Tip: To set a diagnostic code as a favourite, in the list, select the star icon next to it. Every time you create a bill, starred favourites appear first in the list.

Service Date

If you started the bill from an encounter (that was started from an appointment) or from the Visits dashboard, the Service date matches the appointment date.

If you started the bill from the patient's chart, the date defaults to the date you created the bill.

To change the date, click the calendar icon and select a date, or enter the date in the field.

Time Spent (Minutes), Start Time and Finish Time

If you started the bill from an encounter (that was started from an appointment) or from the Visits dashboard, the Start Time matches the appointment time. The Time spent (minutes) and Finish time is pulled from the appointment type.

If you started the bill from the patient's chart, the Start Time defaults to the date you created the bill.

To change a time, click the clock icon and select a time, or enter the time in the field.

You can also enter a value in the Time spent (minutes) field. The Finish time is automatically changed.

Facility

Your default facility (set in your billing settings) is selected. If the service was performed at another facility, select it from the list.

Start typing the name of the facility to search the list.

📌 Note: If the facility is a hospital, by default, no tray fee is applied. To apply a tray fee, in the Advanced Fields, select Override Tray Fee.

Conversely, if the facility is an office, the tray fee is applied by default. Select Override Tray Fee to remove the tray fee.

Functional centre

Functional centre within the facility where the service was performed, if applicable.

Location

If the service was not performed at a registered facility, select the location (home, school or other).

Action code

Indicate whether you want to (A)dd, (C)hange, (R)eassess or (D)elete a claim. Defaults to (A)dd. For more information on other action codes, see Managing and reconciling provincial bills.

Referring Practitioner

Select this checkbox and enter the name or billing number of the provider who referred the patient to you, if applicable. For more information, see Adding a referring provider to a provincial bill.

📌 Note: If the patient has a referring practitioner recorded in their chart, the provider is automatically added.

4. Select Show Advanced Fields to view additional fields.

Field

Description

Admission date

If the service selected is a hospital visit (03.03D), select the date the patient was admitted to the hospital. See Billing for hospital or long-term care visits.

Encounter

If the provider has seen the patient more than once on the same day, indicate during which visit (first, second, third, etc.) the service was performed.

Select a value (1-9) in the list.

EMSAF

Select this checkbox if the service has an added level of complexity and you want to claim a higher rate through the Extraordinary Medical Services Assessment Fund (EMSAF).

You are required to provide additional information. You can explain the circumstances using the Supporting text.

Good Faith

Select this checkbox to submit a good faith bill for a patient who is eligible for healthcare, but doesn't yet have a PHN number.

Claim Amount Override

Select this checkbox if you are claiming a different amount than the normal amount paid for the service.

Confidential

Select this checkbox if the patient asked that the service remain confidential. The service will not be displayed on their Statement of Benefits Paid.

Override Tray Fee

Select this checkbox to remove or add the tray fee (implicit modifier).

If the facility is a hospital, by default, no tray fee is applied. Select Override Tray Fee to apply a tray fee.

Conversely, if the facility is an office, the tray fee is applied by default. Select Override Tray Fee to remove the tray fee.

Paper Supporting Documentation

Select this checkbox if you are sending additional paper documents in relation to the claim.

Newborn and

Mother's PHN

If the patient is an infant who hasn't yet received a provincial health number, select one of the available codes.

You must also enter the Mother's PHN.

See Billing for a newborn baby without a provincial health number.

Pay to code

Identifies the person or organization that is to receive the claim payment.

The provider’s default Pay To code is selected by default, and in most cases is set to BAPY - Business Arrangement (meaning the payment will go to the provider’s BA number).

To send the claim to another Pay to code, select another code from the list:

  • CONT - Contract Holder

  • RECP - Service Recipient

  • OTHR - Other

  • PRVD - Service Provider

Intercept reason

If the payment for the claim is to be intercepted by Alberta Health (e.g. not to be mailed directly to the payee), select PKUP - Hold for pickup.

📌 Note: This code cannot be used if the Pay to code is BAPY.

Locum BA

If you are performing the service as a result of a Locum arrangement with a second provider, enter the BA number of the provider you are working for.

Pay to ULI

If you selected Other as the Pay to code and you know the Unique Lifetime Identifier (ULI) of the other person, enter the ULI in this field.

Orig. facility

The facility where the encounter with the patient occurred, if different from the facility where the service was performed (such as specimen/procedure or blood sample/ECG/X-ray taken in one facility and tested/interpreted in another).

Enter the code of the facility in this field.

Orig. location

This field should only be used if the encounter with the patient occurred somewhere other than where the service occurred, and that location is not a registered facility (home, school or other).

If the code OTHR is selected, the exact location must be provided in the supporting text.

⚠️ Important: The Orig. facility and Orig. location can't both be used on a single claim.

Edit supporting text

To send additional information to AHCIP regarding this billing item:

  1. Click Edit supporting text.

  2. In the Supporting Text window, enter a comment and click Update.

5. To save or update the billing item, click outside the Edit Alberta HLink Billing Item window. The service code is added to or updated in the bill.

Updated August 8, 2022

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