Diagnostic codes and rejections
| Alberta Health Services will reject your claims if diagnostic codes are usedwhen billing an anesthetic. This results in longer wait times for you to get reimbursed. You can find out how to solve these issues here. | DX |  | 933 KB |
APS Billing
| 16.91B Epidural followup visit. You may bill up to 4 visits per day. Each visit must be entered as a separate encounter up to 2 visits may be billed with a unscheduled surcharge (WK, EV, NTPM, NTAM). | 16.91B |  | 983 KB |
Multiple encounters OB | Multiple claims for 16.91G on the same day will not pay on the same encounter
Epidural Monitoring (16.91G ) is billed in 5 minute units. Generally these units must be aggregated for each patient of the course of an OB shift and then submitted together in one encounter. | 16.91G |  | 499 KB |
Out of Province Invalid ULI | Alberta Health Services in at certain sites generates hospital specific ULI codes that can't be used for out of province billings.
This results in out of province rejections. | Multiple |  | 933 KB
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OB billing - Epidural insertion/monitoring
and C-Section billing | Generally 16.91C and 16.91G should be billed together on the same encounter
C-sections are usually a new encounter they must submitted separately with a different encounter number or they will be refused. | 16.91C and
16.91G |  | 412 KB |
Modifying claims that have already been
paid by Alberta Health | If I make an error or want to change a claim that has already been paid, how do I change this claim?
? How can I alert StatGO agents if I feel there is a problem with a paid or resolved claim? | Multiple |  | 714 KB |
Pay your invoice via Credit
Card | Securely and
conveniently pay your bill via credit card | N/A |  | 349 KB |
Billing Reports | Reports to help you understand your billing! | N/A |  | 593 KB |
Good Faith Billing | Good Faith Billing is intended to cover Alberta residents who are eligible for health care - but do not yet have an AB Health Care Number.
The scope of Good Faith payments is quite limited and the rules are restrictive | Multiple |  | 1 MB |
Modifiers causing Rejection/Underpayment | Specific surgical modifiers are not payable to anaesthesia. If added these will cause rejection or underpayment of your claims. | Multiple |  | 188 KB |
Billing Multiple Encounters | Multiple encounters can be entered into the software by changing the encounter number
Submitting with the correct encounter number will reduce your rejections | 16.91 |  | 738 KB |
Split Cases | Cases "split" between colleagues are usually billed by one physician who then reimburses the other.
Can your agents help me figure how payments for the case should be divided? | N/A |  | 2MB |
Organ Donor SOMB Codes | Suggested advice from the organ donation program on anesthesia billing for organ donation cases | 62.3B, 45.6B, 49.5B, 45.5B, 64.81B, 13.99M |  | 368 KB |