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Provincial (Medicare) billing (PEI)
Creating provincial (Medicare) bills from encounters (PEI)
Creating provincial (Medicare) bills from encounters (PEI)
Updated over a week ago

⚠️ Important: You must be integrated with Health PEI to bill in the CHR. Your clinic lead must contact the TELUS Health Support team through the in-app support bubble requesting them to set up your CHR account to bill.

If you are a provider, the standard and most efficient way to create bills is from an encounter that is linked to an appointment. For example, you see a patient for their annual physical exam, create an encounter and create a provincial bill from the encounter. The bill is automatically linked to the appointment - making it easier to confirm that all your appointments are billed.

Steps

1. Start an encounter from an appointment. See Other appointment actions.

2. If applicable, select an encounter template (with or without billing items added). See Starting an encounter.

3. In the Billing Items section of the encounter, modify the Insured Payment Detail or Health PEI Payment Detail fields, as necessary. See Modifying a provincial bill's billing practitioner, location, specialty and other information.

4. To add a billing item (service code) to the bill, click Insured Billing.

📌 Note: If you selected a template with insured billing items added, the billing items are displayed. Click a billing item to modify or delete it.

5. Enter the service code information. See Adding and modifying billing items (service codes) for your provincial bills (PEI).

💡 Tip: You can quickly bill services codes that have been previously billed for the patient by clicking the icon next to Insured Billing and selecting the billing item.

6. To save the billing item, click outside the Edit Billing Item window. The service code is added to the bill.

7. To add additional service codes, click Insured Billing.

8. To edit or delete a billing item, click it.

9. Sign your encounter.


📌 Note: The billing items do not appear in the Insured Billing for this patient or the Billing dashboard until you sign the encounter.

If your default billing status is Ready to Submit and there are no errors with the bill, the claim is submitted to Health PEI and the claim status updates to Submitted.

📌 Note: All Ready to Submit bills are submitted to Health PEI as a batch each day at 6pm.

⚠️ Important: The CHR has built-in billing rules for certain codes and specialities. When you save a billing item, a soft validation takes place. If there is any incorrect or missing information in your bill and your default billing status is:

  • Draft - a Validation Error window appears and the encounter is not signed. Fix the issue and attempt to sign the encounter again.

  • Ready to Submit - the encounter is signed but the bill is not submitted to Health PEI. The status of the claim is Attention Required and the individual bill items have a status of Invalid. Fix the issue. Once there are no errors, change the claim status back to Ready to Submit so the claim can be submitted to Health PEI.

Updated January 19, 2022

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