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Medical Billing for Alberta Physicians

Billing Alberta Health Has Never Been Easier

Why ClinicAid is the only choice for Alberta doctors

Intelligent billing shortcuts and tools. Submit a week's worth of invoices in seconds

Smart billing logic to cut down initial entry errors, superior rejection handling

Instant service code and dx code search fields with current updated SOMB

Full referral provider Billing Number search fields as provided by Alberta Health

Submitting claims to Alberta Health

Physicians in Alberta must submit claims to Alberta Health in order to be reimbursed for the medical services they provide to patients insured through the Alberta Health Care Insurance Plan (AHCIP). Sending claims in with the required information will allow the Ministry of Health in Alberta to quickly process them and send payments back to the care provider. In order to speed up the submission and assessment process, Alberta Health Services use an electronic communication system called H-Link.

What is H-Link?

H-Link connects clients (doctors, medical staff, and other health care professionals) to Alberta Health's mainframe. Clients are able to send their billing and claim information through their computer directly to Alberta Health for assessment.

Who is allowed to use H-Link to submit claims?

Health care service providers, their staff, or service bureaus are able to submit their claims through H-Link. ClinicAid customers designate our company as their "accredited submitter" for the submission of their claims to H-Link when signing up for their business arrangement.

Medical claims submitted through H-Link

Different types of claims can be submitted through H-Link from various medical professionals. Most care providers will submit claims for services that fall under the regular Schedule of Medical Benefits (SOMB) which provides details regarding medical benefit prices and procedures, governing rules, fee modifiers definitions, and explanatory codes.

Certain health services provided in specialties such as podiatry, podiatric surgery, optometry, and oral and maxillofacial surgery fall under the Allied Health Services Schedule of Benefits.

How the Alberta medical billing cycle works

Alberta Health completes a billing cycle every week. Cut-offs, processing, and payments are all done within a week's time, with payments being made for the previous week's claims.

The general rules for submission cut-offs, processing, and payments for Alberta's physicians and medical professionals are as follows:

  • Claims should be submitted before Thursday at 12:00 p.m. MST. Claims received after 12:00 p.m., but before the end of the business day, are often also accepted.
  • Claims submitted by the Thursday cut-off will be processed over the weekend and remittance files will be received by Sunday evening at the latest.
  • Payment of approved claims is made during the following week, usually 7 days after the assessment of claims has been received.

Submitting claims to Alberta Health using ClinicAid

ClinicAid's medical billing software streamlines and simplifies the submission of claims to and receival of assessments from H-Link. Once the correct information is completed in a provider's ClinicAid account, the connection to H-Link will be made automatically and claims can begin to be submitted. All claims will update with the applicable statuses as claims are processed and received back from H-Link. Any rejected or underpaid claims will be visible directly in the user's dashboard to be dealt with as necessary.

Submitting reciprocal medical billing claims

Out-of-province patients require a few more details in order for claims to be assessed and paid out properly through the reciprocal medical billing system. ClinicAid automatically sets up claims for out-of-province patients to link them to the correct province so that they can be processed and paid out quickly. More specific details about reciprocal billing for Alberta's care providers is available on the ClinicAid blog.