Learning Materials

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.DX933 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).16.91B983 KB
Multiple encounters OBMultiple 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.
16.91G499 KB
Out of Province Invalid ULIAlberta 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.
Multiple933 KB
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
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?
Multiple714 KB
Pay your invoice via Credit
Securely and
conveniently pay your bill via credit card
N/A349 KB
Billing ReportsReports to help you understand your billing!N/A593 KB
Good Faith BillingGood 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
Multiple1 MB
Modifiers causing Rejection/UnderpaymentSpecific surgical modifiers are not payable to anaesthesia. If added these will cause rejection or underpayment of your claims.Multiple188 KB
Billing Multiple EncountersMultiple encounters can be entered into the software by changing the encounter number
Submitting with the correct encounter number will reduce your rejections
16.91738 KB
Split CasesCases "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?
Organ Donor SOMB CodesSuggested advice from the organ donation program on anesthesia billing for organ donation cases62.3B, 45.6B, 49.5B, 45.5B, 64.81B, 13.99M368 KB