2020-01-21

Connect Care Professional Billing Progress

There are 3 professional billing relationships that physicians can enter into with Connect Care, based upon how service claims are documented and how they are managed:
  1. Independent Charge Capture & Independent Claims Management - where physicians track and record their charges outside of Connect Care and use a third-party billing service to submit claims and manage responses.
  2. Connect Care Charge Capture & Independent Claims Management - where physicians use CIS tools to capture information to support professional billing claims, generate a report or export of the data, then use a third-party billing service to submit claims and manage responses.
  3. Connect Care Charge Capture & Connect Care Claims Management - where physicians capture charges using CIS tools and rely on the CIS and AHS billing services to take care of claims submissions and response management.
Option 3 affects many wave 1 physicians, as it applies to those employed by Alberta Health Services or contracted through alternate reimbursement plans. Both physicians, who have moved from paper to digital service documentation, and AHS, which has rapidly expanded and upskilled a central billing management service, have experienced a lot of change! Overall, uptake of Connect Care professional billing has been remarkably rapid, effective and efficient.

Of the ~400 physicians adopting option 3, 94% are already using the full Connect Care billing functionality (the remaining physicians are not active users yet). Over 115,000 claims have been entered with the majority requiring no further intervention from the physician. And information burdens steadily decrease as physicians get better at automating inclusion of needed information (like a referring physician for many billing codes).

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