Chapter 1: Medical Billing in Alberta Medical billing may have a (well-earned) reputation for being complicated, but with a solid foundation of the basics, it can quickly become a straightforward part of your day. Download the full version of our Ultimate AHCIP Billing Guide for the tips you need to start billing accurately from the start. Here is a brief overview of what we’ll cover in Chapter 1: 1.1 Physician Payment Models Canadian doctors get paid in a variety of different ways. Depending on your situation, you may even be compensated through multiple payment models at the same time. In the Ultimate AHCIP Billing Guide, you’ll learn the basics of the three most common payment models: Fee-For-Service Salary Alternative Relationship Plans (ARPs) Did you know? Alberta Health offers several ARP models: Academic Medicine and Health Services Program (AMHSP) Clinical Alternative Relationship Plans (ARP) Annualized Clinical Alternative Relationship Plan (ARP) Sessional Clinical Alternative Relationship Plan (ARP) Blended Capitation Clinical Alternative Relationship Plan (ARP) 1.2 The AHCIP Schedule of Medical Benefits This section of our Ultimate AHCIP Billing Guide offers a quick overview of the Schedule of Medical Benefits (SOMB).This is a list of medical benefits insured under the Alberta Health Care Insurance Plan and is where you’ll find descriptions for fee codes and the dollar amount each one pays. Did you know? The SOMB is more than 1,000 pages long! (Thankfully, most specialties have a core set of frequently-used codes and rules, which makes billing less daunting than it seems.) 1.3 How Claims are Submitted and Processed Claims get submitted through the electronic data system called H-Link. H-Link is a secure web service that allows third-party software providers (billing services) to submit claims to AHCIP on your behalf. When you sign up with Dr.Bill, there is no need for you to register with H-Link since we are already connected. 1.4 How And When Physicians Get Paid AHCIP works on a weekly payment schedule. The cut-off date is every Thursday at 4:30 p.m. and payment is made on the Friday of the following week for any claims submitted prior to the Thursday cut off. Payments will be deposited directly into your bank account. 1.5 AHCIP Reports You’ll Receive Shortly after you submit your claims, you’ll receive two reports: a Remittance Advice (RA) Report and an Error Code Report. These reports are helpful for bookkeeping and essential for keeping track of claims. Decode Error Reports Use our explanatory code list to quickly find error code explanations so you know what to do to correct your claim.
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