Several insurance companies are part of the TELUS eClaims service. If you regularly bill eClaims-enabled insurers, it is best to integrate your CHR with TELUS Health eClaims. You can then create, submit, and track insurance claims for all TELUS Health eClaims-enabled insurers from the CHR, streamlining your billing workflow.
For the insurance companies not part of the eClaims service, you can add them to your CHR as Payment Issuers and then create all eClaims and other third-party insurance bills from the Insured Billing section of your CHR.
When you create the third-party insurance bill in the CHR, you can at the same time access the insurance company portal and have both windows open at the same time. This will assist you in quickly updating the bill in the CHR based on the insurer's response on the portal, saving time and simplifying the bill reconciliation process.
Depending on your workflow and if a patient has an appointment, you can create a third-party bill from:
An encounter (for providers who want to bill during or after each patient visit). Refer to Creating a third party bill from an encounter note.
The patient’s chart (for staff or providers who want to bill services without a visit or encounter)
The Billing dashboard. Refer to Quick billing from the Billing dashboard.
The Visits tab (for staff or providers who want to bill from a list of appointments).
Steps
1. Open the Insured Billing window from the patient chart or the Visits dashboard.
From the patient chart:
a. Click Start/Open > Insured Billing, and the Insured Payments section opens.
b. At the top-right corner, click +New Payment, and the New Insured Payment window opens.
From the Visits dashboard:
a. From the main menu, click Visits. The Visits window appears with a list of today's appointments.
b. Select an appointment from the list. A patient information window appears.
c. Click the Insured tab > Add Insured Payment and the New Insured Payment window opens.
2. Under Payment Issuer, select the insurance company you want to bill.
3. If needed, modify the Billing Practitioner, Service Date or other bill details. Refer to Modifying a third party bill's billing practitioner, location and other bill details (with eClaims enabled).
💡 Tip: You can use billing templates to speed up your billing process. In the top-right corner, click Template. For more information, refer to Using billing templates.
3. To add the service codes to the bill, click +Add Fee Item.
💡Tip: To select a past billed item, click the history icon.
A New Billing Item window appears.
4. Complete the relevant fields using the below table:
Field | Description |
Code/Description | Type the code and description of the service offered.
To search by code, start typing the code in the first search box. To search by description, start typing the description in the second search box. Select a match from the list.
📌Note: The fee code list that appears is based on the billing code template associated with the payment issuer you selected. To add more codes to the billing code template, refer to Creating or editing third-party billing code templates.
💡 Tip: Select the star icon next to the specific code to save the code to your favourites. Every time you create a bill, the starred favourites appear first in the list. |
Base Amount | If a base amount was specified in the billing code template for this insurance company, the amount is pre-populated. Change it, if necessary. Otherwise type the fee amount |
Quantity | Type the number of units or click the up or down arrow to change the number of units. |
Diagnosis Codes | Enter the diagnosis code, or start typing a description to search for and select a diagnosis code from the list.
💡 Tip: Select the star icon next to the specific diagnostic code to save it to your favourites. Every time you create a bill, the starred favourites appear first in the list.
📌 Note: The list of diagnosis codes available depends on what is selected as your Default Diagnosis Template in Settings > Templates. See Configuring diagnostic codes for your account. |
Service Date | Defaults to the Service Date. To change the date for this specific billing item, click the calendar icon or manually type it. |
Time | The time defaults to the time you created the bill. To change the time, click the clock icon or type it. |
5. When you are finished adding the service code, click outside the New Billing Item window to save your changes.
6. To add additional service codes, click +Add Fee Item.
7. To edit a billing item, click it and make the required changes.
8. To delete a billing item, click it and click the trash can icon in the top-right corner.
9. Type any Internal Notes. . These notes are not included in the submitted claim.
10. Click Save.
📌Note: You can save the claim in Draft status with only a fee code and base amount.
11. To submit the claim to the insurer, click Insurer portal, create, and submit the claim. Based on the insurer's response, update the claim status in the CHR.
💡 Tip: To create an invoice to send to a third party, click the printer icon. See Generating a PDF invoice for third-party claims (with eClaims enabled).
Updated June 19, 2024