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.

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

  • Refused (refused by AHCIP)

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

The error or refusal reasons display below the billing item 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 clinic 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: When you click the Patient column, the patient's chart opens instead of the bill.

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

6. Using the following table, manage the bill.

To do this...

Do this...

Edit and submit or resubmit the bill

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

2. At the top of the bill, in the Status drop-down, select Ready To Submit.

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 drop-down, 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.

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

Updated June 29, 2022

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