How to fix a rejected Out Of Province claim:


To fix a rejected out of province claim is a two-step process. First update the patient record and then reload the patient information into the invoice. 


To do so, follow these two steps:


1. Update the patient's details under your 'Manage Patients' menu.
 

The required fields for out of province claims are:

  • First name, last name
  • Healthcare Type (province patient is from) 
  • Health Number (out of province health card # - enter in Health and Service Information section - see screenshot) 
  • Gender
  • Date of Birth
  • Full Address - address line 1, city, province, and postal code.


Then click the blue “Update Patient” button to save.

 



2. Once this is done, edit the invoice in question and hit the 'reload' button next to the patient's name (attached image). This will add all the updated patient details into your invoice automatically.



 


To update Invoice only:
If for some reason you wish to update the invoice only and not the patient record as well, you can follow these steps:

  • First, under the 'Advanced' tab, move the ‘Health Number’ to the ‘Registration Number’ field.

  • Second, set the ‘Recovery Code’ to the appropriate code that matches the province the patient is from.

  • Last, fill out the 'Service Recipient' demographic section of the 'Demographics' tab with gender and full address including postal code.



Additional Resources:

Alberta: How to bill an Out Of Province claim

How to create an Out Of Province claim

How to get Out Of Province Health Numbers

 

Out Of Province Health Card Number Formats for Provinces and Territories 

 

Alberta Health Ministry - out of province billing