Business Arrangement Number
To use Logic Resources as your accredited submitter you need a business arrangement number that lists us as your submitter. You will probably need to apply for a new BA number using AHC form 913. Complete this form and send it directly to Alberta Health. If you have never had a BA number with Alberta Health you will need to attach a copy of a voided cheque along with your application form. If you have previously submitted a voided cheque to AHC for another BA number then you do not need to send another one.
If you have a BA number that has never been used for submitting claims then it can be assigned to Logic Resources. You will need to complete the form 2096 and fax or email it to us. Complete the top section of the form and sign and certify the bottom left section of the form and send it to us. We will complete the middle portion and sign and certify the bottom right section.
When applying for a new BA number, please make sure to set the effective date back to include the first service that you will be billing for.
The deadline for claims submission is Wednesday evenings at 7:30pm.
When you make a claims submission you will receive an email from our server within 5 minutes telling you that your submission has been received and processed. If there are any errors in any of the claims, the email will list them. Always wait for your confirmation email. Also the bottom of the email may contain any important messages that pertain to software updates, changes to submission schedules or information from Alberta Health.
Claim Submission Valid Period
You have 180 days from the date of service or the date of the last transaction to submit your claims to Alberta Health. However, this should not be the norm. Also bear in mind that for some provinces the period to haver your claims accepted is only 3 months.
If you are at a new clinic or facility, then we won't have the facility number in the validation tables. You will need to provide us with your new facility number so that our software will accept it.
I Am a New Doctor - This is All Confusing
The billing process is very complex and if not done right will result in lost income and/or delays in payments. You need a business arrangement number to start with. Make sure the effective date of your BA number is dated back to the date you will be billing for. You can pre-date your application back three or four months. If you know the name of your submitter enter this on your application form as it saves a step. When you get your business arrangement number make sure there is a submitter is assigned to it. If not you will have to fill out and submit a 2096 form.
Here are some resources to help you navigate the system:
Locum Services Configuration
If you are working as a locum there are four ways in which your claims can be submitted and processed by Alberta Health. You need to consider:
- Will the payment be made to the practice or the locum's BA number
- Will the claims be submitted through the practice's submitter or through the locum's submitter
The physician paramers file of your software needs to be configured in one of the following ways:
Payment is made to the practice using the practice's submitter: Enter the practice's BA number in the Bus Argmt field and leave the locum Bus Argmt field blank
Payment is made to the practice using the locum's submitter: Enter the practice's BA number in the Bus Argmt field and enter the locum's BA number locum Bus Argmt field blank
Payment is made to the locum using the locum's submitter: Enter the locum's BA number in the Bus Argmt field and locum Bus Argmt field blank
Payment is made to the locum using the practice's submitter: Enter the locum's BA number in the Bus Argmt field and enter the practice's BA number locum Bus Argmt field blank
Payment File Processing
The submission deadline is Wednesday evenings at 7:30 pm. Claims received before this time will be processed and paid by Alberta Health on the Friday 9 days later. The electronic payment file is generally available by Tuesday, three days prior to the Friday that the payment will be made.
Refused or Rejected Claims
If a claim is rejected by Alberta Health a code is provided to explain the reason why. In our software you can look up the explanantion code table to find the reason why the claim was refused. You can also look at the Medical Billing Resources page under Support Options on this website to download a PDF document with all the explanation codes.
This page also provides a QR code where you can scan it into your mobile phone or tablet and have the codes on your device.
Resubmitting Rejected Claims
A claim that has been rejected or refused by Alberta Health (code RFSE) has to resubmitted as a new claim with a new claim number. A claim that has had its payment reduced or is paid at zero is handled entirely differently when resubmitting it.
With claims that have been reduced or paid at zero, you have to resubmit the original claim again with any changes to the service code or encounter number that you need to make. You also need to specify the action code for the resubmitted claim - C, D or R. The help file of our software explains the process in detail..
You do not need to become an accredited submitter to submit claims to Alberta Health when you use our software. To use any of our medical billing software packages, we will assign you a submitter prefix and source code.
We act as your accredited submitter and you do not have to bother with that aspect of things.