ClinicAid Alberta - Getting Started Guide
Setting up your provider record
Connecting your account to H-Link
1) Doing a demographic import of patient records from a previous system
2) Adding a patient record from the Manage Patients section
3) Creating a patient record from the Create Invoice page
1) Completing the patient information section
2) Completing the provider information section
3) Adding line items with appropriate service codes, fee modifiers, and diagnostic codes
4) Adding any additional information to the claim
5) Saving and submitting your claims
Contacts and additional resources
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 brand new ClinicAid account. In order to start setting up your account for billing, you’ll need to log in. Go to the clinicaid.ca homepage and click on the Login button in the top right-hand corner. Enter your email and password on the login page and hit the Get Started button to access your account.
We recommend using Mozilla Firefox or Google Chrome for any of your ClinicAid activities as these are the browsers that will ensure the best ClinicAid experience. We don’t advise using Safari or Internet Explorer for your ClinicAid billing purposes.
Once you’ve logged in with your email and password, you will reach your Dashboard which should show three empty sections (Invoices Requiring Action, Billing Opportunities, and Unsubmitted Invoices) 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 Alberta’s H-Link electronic submission system. This is a step-by-step written guide to how to do just that! Please feel free to view our video tutorial that also goes over these instructions.
Setting up your provider record
The first thing you’ll need to do in order to complete your account setup is to create a provider record. 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 record(s) 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.
Step 3: Click on the green “Add Provider” button.
Step 4: Complete the provider information, including:
- First and last name: the physician’s name
- 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. Jane 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 you’ve 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).
*Please note: 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 don’t yet have a BA number or if you have one, but it’s 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 that’s 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 aren’t 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. A 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 Health’s facility listing. If you’re unsure of which functional centre you provide services in, give Alberta Health a call to confirm.
*Please note: A physician may have multiple facility numbers and functional centres that they provide services in. The information saved in the provider record should be the primary or default facility and functional centre as it will appear on all the claims created using that particular provider, unless modified for each individual claim.
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 using the Advanced tab when creating an invoice 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. You can view the record by clicking the name of the provider or the little grey eye button on the right. You can make edits to the record by clicking the name of the provider and selecting edit, or by clicking the blue pencil icon on the right. Providers can be set to “inactive” if needed.
A completed provider record should look something like this:
You’ll need to set up separate provider records for each of the physicians the billing will be done for using this ClinicAid account.
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 patient’s personal health number (PHN). This means that you will need to create patient demographic records in ClinicAid with your patients’ details before beginning to submit claims.
There are three ways to add new patients into your ClinicAid account, outlined below.
1) 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 directly into ClinicAid so that you don’t 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-type format will work).
If you don’t have direct access to your patient data, you will need to ask your current or previous 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 find out more about doing an import of your data.
2) Adding a patient record from the Manage Patients section
You can add individual 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 your new ClinicAid account.
Step 1: In the Manage Patients section, you will see two options for creating a new patient record:
Option 1: Click the green “Add Patient” button to open up the complete patient demographic form which will allow you to fill out all of the patient’s details.
Option 2: Click the green “Quick Patient” button to open up a shortened version of the complete patient demographic form. You can set which fields to display by default on this form in the Preferences > Settings > Patient Quick Forms section.
Step 2: Select whichever of the two options is best suited to your practice and begin entering the patient’s details. In Alberta, all claims must contain the following patient information in order for them to be processed properly:
- Health Number: 9 digit personal health number of the patient.
- Healthcare Type*: the issuing province or territory that the patient is covered under.
*Please note: This field must be set as the correct province or territory for out-of-province patients and the patient record must also include the patient’s 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 isn’t completed, it may affect certain invoice values in ClinicAid.
Step 3: Click the blue “Create patient” button to save the record once you have added the desired amount of information.
You can continue adding patient records by repeating this process.
3) 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. It is also especially useful for physicians that don’t have regular patients.
When you click on the Create Invoice section in the left-hand 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 when creating an invoice. However, if the patient doesn’t already exist in your system, you will need to add them following these steps:
Step 1: Click on the + icon next to the patient field in order to open up the “Add a new patient” quick form.
Step 2: Complete all of the desired patient information.
Step 3: Click the blue “Create patient” button in order to save the record. This patient’s record will now join your other records in the Manage Patients section and will be searchable for future billing.
Once you’ve added patient records to your ClinicAid account, you’re ready to start creating invoices!
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. They are as follows:
1) 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 physician’s name or practitioner ID. If they don’t 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.
2) 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 a physician or select them from the list that appears.
*To set a default provider, click the Edit pencil icon next to the Default Provider setting (found at the top right of the screen next to your account information) and select the provider’s 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 this provider’s details.
3) 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 a code by number or description. For longer descriptions, use your mouse to hover over the short descriptions displayed 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 today’s 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.
4) 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 patient’s record.
5) 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 submit the claim immediately by clicking the green “Send Now” button at the bottom of the invoice, but we recommend saving the claim by clicking the blue “Save” button instead. Saving your claims will allow you to do one final review before sending them off 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.
Alberta Health Billing Cycle
The billing cycle in Alberta is one week long and follows this pattern:
- 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). You can view the various statuses in the Manage Invoices section. Rejected or underpaid claims will also be displayed on the Dashboard in your Invoices Requiring Action section.
Invoices requiring action will have this status until you edit them to “fix” the issue displayed by the rejection reason and code, or until you manually settle the claims to acknowledge and accept rejected or underpaid claims based on their rejection reason and code.
You can submit claims as often as you’d like and you can use ClinicAid’s handy features, such as favourites lists and default invoice templates (set up in the Preferences section of the left-hand menu), to streamline your submission process.
For help with setup or questions about how ClinicAid’s 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 ClinicAid’s Customer Support Portal to find additional resources to help you familiarize yourself with your new account. There, you’ll find links to our tutorial videos, as well as FAQs and written guides to help you become a ClinicAid billing pro in no time! You can also visit our blog for updates and more relevant information about ClinicAid. Feel free to 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 the patient health number, date of service and service code. Occasionally they will ask you for a Claim Number if they are having trouble locating the claim in their system which you can find in the transaction history on your view invoice page.
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).
We hope this guide has helped you familiarize yourself with your ClinicAid account. Please let us know if you have any questions and happy billing!