The first step in creating a claim is creating the insurer. To do this, ensure you are logged into an account with at least Administrative Staff/All Billing Access permissions.
Create an Insurer
In Settings on the left hand side, scroll down to the Billing section - Insurers
Select New Insurer from the top right:
The next step is to select the Insurer Type:
Note: If you are looking for ICBC related information check out the discipline specific documents here.
After selecting the Insurer Type, you’ll need to enter in the insurer name (required) and contact information (optional).
You may also enter a portal if appropriate. This could be a government billing portal such as HCAI, a third party billing portal such as Telus E-claims, or even your email program. This will allow you to launch the portal directly for claim submissions. As a heads up, you can now set up a direct integration with Jane and TELUS eClaims!
Here are some of the common portal addresses:
Medavie Blue Cross: https://secure.medavie.bluecross.ca/eai/login
Pacific Blue Cross: https://service.pac.bluecross.ca/ACESWeb/Pages/Authentication/SignIn.aspx?userType=4
Telus E-Claims (including WSIB): https://providereservices.telushealth.com/
You can view some more information about managing claims and portals on this guide: Working with Claim Submissions - Online Insurer Portals.
Determine Patient’s Fee
Next you’ll need to set how the patient is going to be billed.
To bill the full amount of an appointment and charge nothing to the patient, leave both the “user fee” and the “pay remaining” blank:
To bill a set user fee to a patient (say, $30 for an MVA patient), it would look like this:
Commonly though, a patient pays the balance not covered by their insurance (For example, if ICBC pays $24.15 of a $100 appointment, the patient would need to pay the remaining $75.85.) To do that, here’s what it would look like:
You don’t need to worry about setting an exact amount here. The amount billed to the patient is based on the coverage set on the policy you’ll create following this guide: Creating a Patient Policy.
If you have any questions along the way, please email us at firstname.lastname@example.org to discuss your options.