When you submit claims to AHCIP through H-Link, H-Link may auto-refuse some incorrect bills. When AHCIP rejects a claim, the CHR flags the associated bill as Attention Required. The CHR can also identify an issue with a bill prior to submission and automatically flag it as Attention Required.

You manage attention required bills from the Billing dashboard. Here, you can filter the list of bills to display all the bills that require your attention.

📌 Note: If AHCIP rejects an entire bill (all fee items), the status in the CHR shows Cancelled. Use the AB Cancelled Billing dashboard to manage these bills. For more information, see Managing cancelled bills.

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

  • Refused or Cancelled (refused by AHCIP)

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

The reasons for an invalid or refused billing item display below it as Error Messages or Messages.

Steps

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

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

  • Status: Attention Required

  • Insurer: Alberta Health Care Insurance Plan

  • Service Date: Set the service date range for which you want to view bills.
    💡 Tip: To filter bills by paid date, in the Search By list, select Paid Date.

  • Billing Practitioner: Select the providers for which you want to view bills.

  • Location: If your clinic has multiple locations, select the locations for which you want to view bills.

3. Click Apply. A list of bills displays.

4. To open a bill, click its description.

💡 Tip: Clicking a patient's name opens their chart instead of the bill.

5. Under each billing item flagged as Refused, Cancelled or Invalid, review the messages describing reason for the refusal or error.

6. Using the following table, manage the bill:

To do this...

Do this...

Edit and submit or resubmit the bill

If the status is Cancelled:

1. Create a new bill from the Insured Billing section of the patient's chart.

Ensure the Billing Practitioner and Service Date are set to match the one on the original claim.

2. Add the same fee item(s) as the original bill. Click the clock icon to view the Latest Billing Items and select the fee item from the list.

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

4. At the top of the bill, in the Status list, select Ready To Submit.

If the status is Refused:

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

2. Click the blocked icon beside the billing item,

A checkmark displays.

3. At the top of the bill, in the Status list, select Ready To Submit.

📌 Note: If you change status to Ready to Submit and forget to click the blocked icon, the status stays as Refused. Remember to click the blocked icon to display the checkmark.

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

1. From the bill, open the patient's 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 list, select Ready To Submit.

Delete an invalid bill

You can delete a bill from the patient's chart.

See Deleting provincial bills.

Mark a refused claim as Cancelled or Completed.

If AHCIP refuses the claim even after you resubmitted it, you can manually change its status to Cancelled or Completed, depending on your clinic’s workflow.

💡 Tip: You can quickly change the status of several bills at once from the Billing dashboard. For more information, see Bulk changing the status of insured claims.

7. Click Save. The bill is updated. It’s submitted or resubmitted to H-Link at 11 a.m. or 3:30 p.m. if applicable.

Updated October 20, 2022

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