Welcome to ClinicAid

Thanks for signing up with ClinicAid! We hope our web-based medical billing software will enable you to bill Alberta Health and Wellness quickly and easily!

 

Now that you’ve signed up, you should have already received your login details via email to access your account. You can start the process of setting everything up for billing by logging into your ClinicAid account.

 

Go to the clinicaid.ca homepage and click on the Login button. Enter your login credentials to access your account. We recommend usin Mozilla Firefox or Google Chrome for any of your ClinicAid activities as these are the browsers that will work best with ClinicAid. We dont advise using Safari or Internet Explorer for your ClinicAid billing purposes.

 

Once you’ve logged in with your email address and password, you will reach your Dashboard which should show 0 Unsubmitted Invoices and 0 Invoices Requiring Action when you first start out. You’ll need to set up your account fully in order to begin creating and submitting your bills properly through Albertas H-Link electronic submission system. This is a step-by-step guide to how to do just that!

 

Setting up your provider record

The first thing you’ll need to do to set up your account is to create a provider record for each physician that the billing will be done for in ClinicAid. If you’ve already been in touch with one of our support reps, this step may already be partially or fully completed for you. In case you haven’t had your provider accounts set up yet, here is what you’ll need to do.

 

Step 1: From the left-hand side menu, click on the Admin section.


Step 2: Click on Providers. You’ll need to set up provider records for the physicians the billing

will be done for.

Step 3: Click on the blue Add a provider button. Step 4: Complete the provider information, including


First and last name: the physician’s name Note: this isn't sent to Alberta Health, could also use as an identifier if multiple provider records set up for multiple locations.

 

Provider billing number: the physician’s 9 digit practitioner ID, as registered with Alberta

Health Services. Do not include the hyphen in the number (i.e. 1234-56789 becomes

123456789).

 

 

Source code: any random two character code. We generally set this field to the initials of the physician (i.e. source code for Dr. John Smith could simply be JS). This code is sent to H-Link and can be used to identify billings when contacting their support department.

 

Skill code: the physician’s primary skill that is associated with their Business Arrangement (BA) number (i.e. skill code for an anesthesiologist will be ANES, skill code for a general practitioner will be GP, skill code for psychiatrist will be PSYC, etc.) This section is a search field so you can simply type in your specialty and you should be able to select the appropriate skill code from the results. If you’re unsure, Alberta Health will be able to confirm what youve registered your BA under. If you are using an alternate skill on a portion of your claims you can identify that on your invoices.

 

Business Arrangement number: a 7 digit number that you will receive directly from Alberta Health that is associated with a method of Payment. Do not include the hyphen in the number (i.e. 1234-567 becomes 1234567).

 

In order to submit through ClinicAid, your BA must be attached to our submitter name and prefix, which is Cloud Practice Inc., prefix: CPI. You can complete this information on the The Accredited Submitter for this BA is” line in Section B of the Business Arrangement (BA) request form (AHC0913). You will need to complete this form with your provider information if you dont yet have a BA number or if you have one, but its attached to a different submitter.

 

If you have an unattached BA number already, you can attach it to our submitter prefix by completing the Submitter/Client Relationship for Electronic Claim Submission form (AHC2096).

 

You can have an unlimited number of BAs so getting a new one thats attached to our submitter

prefix will not affect any of your other BAs.

 

 

Facility number*: each facility in Alberta is registered with a unique facility number. If you’ve just opened up a new facility, you’ll need to register it with Alberta Health in order to receive your facility number. Established facilities should show up in the search results once you start typing in the facility name and you can also save facility numbers that arent in our current list which we update about twice a year, but they must be valid facilities that have been registered


with Alberta Health in order for the claims to be processed correctly. facility listing with many

of the larger facilities is available online if you’d like to consult it.

 

 

Functional centre*: each facility has various functional centres within it that identify where in the facility the service was provided. These functional centres are generally correspondent with a physician’s skill code. Functional centres are usually 3 to 4 letter codes that identify these various locations within a facility. A definition of each of the codes is available in Alberta Healthfacility listing. If you’re unsure of which functional centre you provide services in, give Alberta Health a call to confirm.

 

*A physician may have multiple facility numbers and functional centres that they provide services in. The one set in the provider record should be the primary or default facility and functional centre. If you are working at many different facilities and functional centres with no defined or recurring schedule, it is also possible to leave this information blank and to complete it per bill or with the use of default invoices (invoice templates).

 

Step 5: Click the blue Create provider button in order to save the record.

 

 

Once you’ve completed all of the fields and saved the record, you should see a new provider displayed in the account which, if viewed by clicking the name of the provider or the little grey eye button to the right, should look something like this:


 

Connecting your account to H-Link

ClinicAid has a built-in connection to the H-Link submission system that Alberta Health uses for electronic claims submissions. Once your provider record is completed with all of the required information, you are ready to start creating and submitting bills. No other setup is required.


Adding your first patients

In order to create and submit claims, you will need to link them to a patients personal health number (PHN) which means that you will need to create patient demographic records in ClinicAid with your patients’ information. There are three ways to add new patients into your ClinicAid account.

 

Doing a demographic import of patient records from a previous system

If you were billing through a different software previous to getting a ClinicAid account, it may be possible to import your patient data into ClinicAid so that you dont have to manually enter each patient record into the system. We will need a copy of your data in a comma-separated value (CSV) format (generally an Excel spreadsheet format will work). If you dont have direct access to the data, you will need to ask your current billing software provider for the export or, if the data is on a server within your office, we may be able to access it remotely. Contact a ClinicAid support rep if you’d like to do an import of your data, but are unsure of what this will require.

 

Adding a patient record from the Manage Patients section

You can add patient records by navigating to the Manage Patients section in the left-hand side menu. This will probably be the most efficient way to add a batch of patients when you first begin using ClinicAid and the account is still empty.

 

Step 1: Click the blue Add a patient” button towards the top right corner.

Step 2: Enter the patients data. In Alberta, all claims must contain the following patient information:

Health Number: 9 digit personal health number of the patient.

 

 

Healthcare Type: the issuing province or territory that the patient is covered under. This field must be set as the correct province or territory for out-of-province patients and the patient record must also include the patients address in order for Alberta Health to process the claim correctly through the national Reciprocal Billing Program.

 

Nothing else is required by Alberta Health, but the ClinicAid system will also require you to complete the following in order for the patient record to be set up correctly:

First and last name: enter the name of the patient.

 

 

Birthdate: although this is not required, ClinicAid will give an Acknowledgement message to ensure the user is aware that, if this isnt completed, it may affect certain invoice values in ClinicAid.

In order to view the full patient demographic form, click on the Show Hidden Fields” button.

This will extend the form to a long form which includes address details, default settings for a referring provider, and any default codes or admission dates you may wish to add to a patients record. Additional notes can be added in the Notes text field.

 

Step 3: Click the blue Create patient” button to save the record once you have added all of the information you desire.


 

You can continue adding patient records by repeating this process until you are caught up on your current patient list.

 

Creating a patient record from the Create Invoice page

You can also create patient records directly from the Create Invoice screen. This method will be particularly useful once you already have your patient files set up and are adding new patients as you are doing the billing for them (especially useful for physicians that dont have regular patients).

 

When you click on the Create Invoice section in the menu, your cursor will automatically be in the Patient field. This field is a search that you can type patient names or PHNs into in order to pull up their patient record easily. However, if the patient doesnt already exist in your system, you will need to add them.

Step 1: Click on the + icon in order to open up the Add a new patient window.


Step 2: Complete all patient information desired. For out-of-province patients, click the Show all fields” button and complete the address section of the record as well.

Step 3: Click the Create patient button in order to save the record.

 

 

The patients record will now join your other records in the Manage Patients section and will be

searchable for future billing.

 

Creating your first invoices

There are 5 main sections to complete in order to create and submit your Alberta Health Care

Insurance Plan (AHCIP) claims properly. These are:

 

Completing the patient information section

Step 1: Select the patient you wish to bill for. This field acts as a search so if the patient already exists in your account, simply search for them by name or PHN. If the patient does not yet exist, add the patient record following the instructions above.

Step 2: Once the patient is selected, their information should prefill in the Patient Information section of the invoice.

Step 3: Add a Referral ID if the patient was referred to you by another physician. This field acts as a search so you can begin typing the referral physicians name or practitioner ID. If they dont appear in the search results, you can simply type in the practitioner ID if you know it, or you can


add the provider as a custom referral provider by going to the Admin section in the left-hand side menu, opening the Referral Providers tab, and adding a new referral provider.

 

Completing the provider information section

If you’ve set a default provider in your account (especially useful for sole practitioners), the Provider Information section should already be prefilled. Otherwise, simply begin typing the name of the physician or select them from the list that appears.

 

To set a default provider, click the Edit icon next to the Default Provider setting (found at the top right of the screen next to your account information) and select the providers name you wish to set as the default provider in the account.


To save, click the checkmark. Once this is saved, your new invoices will have the provider

information section prefilled with the providers details.


 

Adding line items with appropriate service codes, fee modifiers, and diagnostic codes

All claims submitted to Alberta Health will require a service code. The majority of service codes require at least one diagnostic code and may have up to three fee modifiers that can be claimed.

 

The service codes and diagnostic codes fields are searchable by code or by description so typing numbers or letters in these fields will automatically display search results. Codes can be selected from the search or typed in. Fee modifiers that are displayed once a service code is selected are the only modifiers that are applicable to the service code.

 

In order to complete a line item, follow these steps:

Step 1: input the appropriate service code. You can search for the code by number or description. For longer descriptions, hover over the short description in order to see the full text. Step 2: complete the calls and encounters fields, if applicable. Calls signify time increments and act as multipliers to fee amounts, while encounters signify a specific visit with the patient when multiple visits are made on the same service date.

Step 3: add any applicable fee modifiers (up to three). The list of fee modifiers that appear in the search results will be the only modifiers that are applicable to the particular service code

chosen.

Step 4: input the appropriate diagnostic code(s). You can search for the code by the number or the word.

Step 5: select the service date. By default, the service date is set to todays date. In order to

select a service date in the past, use the calendar feature.

Step 6: click the black “Add button to add the line item to the invoice.


Please note that there is an “Extra fields” area to enter different claimed amounts when

appropriate.


 

 

You can add as many line items as you’d like for a particular patient. Different line items will be treated as separate invoices by Alberta Health and will be assessed based on the service code and service date.


 

Adding any additional information to the claim

Any other information that may be required in a claim can be set in the Advanced tab on the invoice creation page. This is where any supplemental text for claims will go, as well as where certain indicators such as good faith indicators, newborn codes, and more can be set. This is also where specific claim information for a particular claim can be changed, such as facility number and functional centre, secondary skill code, hospital admission date, and more.



The Demographics tab next to the Advanced tab holds extra information about the service recipient, payee, and referring service provider. This tab is used particularly for out-of-province patient billing where much of the information will auto-fill based on the data saved to the patients record.

 

Saving and submitting your claims

Once you’ve completed all of the necessary information on your claim, you are ready to send it in! You can either do so right away by clicking the green Send Now button at the bottom of the invoice, or saving the claim by clicking the blue “Save” button and reviewing it once more before sending off your claims in a larger batch.

 

To send off your batch of saved claims, go to the Manage Invoices section. The New status (first tab) will display your new, unsubmitted claims which you can then send in a batch by checking the top checkbox (next to Service Date). This will select all of the claims visible on the page and once you click the green Send” button that appears after checking the items, they will be sent to Alberta Health. In order to send more claims than just the 10 visible by default, you can change the amount of items per page using the dropdown at the top of the screen. You can also send just a few claims in by selecting them using the checkboxes, or you can send claims

in individually by clicking the green arrow button at the end of each claim line.

 

 

Once claims have been sent, they will move into the Pending tab until they are assessed by Alberta Health and sent back with updated statuses. You will not be able to edit claims that are pending until you receive a response from Alberta Health on them.

 

The billing cycle in Alberta is one week long and follows this process:

   Thursday: official cut-off is every Thursday at 4:30 p.m.

    Friday-Sunday: claims sent in before cut-off are assessed over the weekend, with a remittance file being sent back from the H-Link system by Sunday evening.

   Monday: all updates to your claims will be reflected in ClinicAid by Monday morning.

    the following Friday: payment is usually made the Friday after claims have been assessed (one week after cut-off).

 

ClinicAid will automatically update the statuses of your claims in the system as soon as we receive the remittance file back from H-Link. Your claims will either be settled (accepted and paid in full) or will require action (rejected, underpaid, or paid at zero). Invoices requiring action will have this status until you edit them to fixthe issue displayed by the rejection reason and code or until you manually settle the claims (to acknowledge and accept rejected claims, underpaid claims, or claims paid at zero based on their rejection reason and code).

 

You can submit claims as often as you’d like and you can use ClinicAids handy features, such

as favourites lists and default invoices, to streamline your submission process.

 

 

For help with setup or questions about how ClinicAids medical billing software works, you can contact us and one of our support representatives will help you as soon as possible. We also have a  video tutorial which you can follow along with in order to set up your account.


Contacts and additional resources

Please visit our YouTube channel for  more videos, see ou blog for more relevant information about ClinicAid, an contact us with any other questions you may have.

 

For specific billing questions about how to claim for certain services or questions about rejected/underpaid claims, it is best to contact the Alberta Health Claims and Assessment office at 1-780-422-1600. They will generally ask for your Claim Number which you can find at the top of your invoice.


For questions about provider registration, facility registration, or to find out which functional centre is the correct one to use for your particular facility and the services you provide, call the Alberta Provider and Facility Registration department at 1-780-422-1522. You can also consult the  Alberta Health Facility Listings for definitions of the various functional centres and a list of the main facilities in the province.

 

Other useful resources include the  Alberta Health Physician Resource Guide (for information about the various aspects of being a practitioner in Alberta), the Schedule of Medical Benefits (for specific procedures lists, fee amounts, and explanatory code definitions), and the  Claims Forms section (for copies of the forms required to set up a practitioner, facility, Business Arrangement, and more in Alberta).