printing claims for patients with canadian addresses

Registering Patients who have Canadian Addresses
  1. On the Patient tab in Registration:

Address 1: Enter the patient’s street address: Number Street Name Suite

Address 2: Enter the patient’s:MunicipalityProvince Code Postal Code CANADA
Example:
Address 1: 11 Pinnacle Ridge Drive
Address 2: CalgaryABT3Z 3N7Canada

Do not enter commas or other punctuation marks in Address 2

If the name of the municipality is more than one word long, enter hyphens (not spaces) between the words

Enter only one space between each address segment

Province code – use the 2 character code; do not spell out the Province name
The following is a listing of Province codes:

AB – Alberta / NS – Nova Scotia / PE – Prince Edward Island
BC – British Columbia / NT – Northwest Territories / QC – Quebec
MB – Manitoba / NU – Nunavut / SK – Saskatchewan
NB – New Brunswick / ON – Ontario / YT - Yukon
NL – NewfoundlandLabrador

Postal Code - may be obtained on the Canada Post website:

  1. Click on “Find a Postal Code” found on the menu at the top of the web page.
  2. Read the directions supplied; and then enter the address for which you need a postal code.
  3. Click on submit. The results will display on the screen. Below is a sample screen shot:

City, State, Zip and Country fields must be left blank.

  1. On the Account tab in Registration:

Enter the words “CANADIAN ADDRESS” in the Account Comments field.
This will help the charge entry staff identify these claims and “hold” them from electronic billing.

Use the same data entry rules when entering subscriber addresses which are Canadian.

  1. In Charge Entry:

Claims for Patients having a Canadian address must be held from electronic billing and printed to paper. In order to assist the charge entry staff in identifying those vouchers which should be held from electronic billing the staff should be trained to check the Account Comments field which is displayed on the Charge Entry screen.

In addition a Claim Type may be created and assigned to the appropriate Carriers. This Claim Type will display whenever a voucher is created and one of the designated Carriers is selected as Payor. (See the online help for details.)

In Charge Entry on the Summary screen the option “Hold Voucher From: Electronic Claim Billing”, must be selected.

Billing File Maintenance

The crystal reports and project documentation needed for this setup are:

  1. BCBSMHCFA1500CanadianAddr.rpt
  2. HCFA1500CanadianAddr.rpt-Generic
  3. BCBSM HCFA 1500 Canadian Address Claim Form.doc
  4. HCFA 1500 Canadian Address Paper Claim Form.doc

These files are stored on: \\apss1\ntierprise\hm NT Library\Ntierprise Custom Crystal Reports\Paper Claim Forms

NOTE: In order to determine which options apply to the Practice,

Have samples of their printed claim forms as they should be sent.

For each Carrier determine whether the Practice is required to submit an Individual Billing number and/or Group Billing number.

  1. Add the following Crystal Reports to the folder “Custom Crystal Reports” which resides on the Practice server, \\<Server Name>\<Practice Name>\Custom Crystal Reports:
  2. BCBSMHCFA1500CanadianAddr.rpt
  3. HCFA1500CanadianAddr.rpt-Generic
  4. Create Paper Claim Formats
    These paper formats support both Canadian and non-Canadian addresses.
  5. BCBSMCAN – (Project Documentation: “BCBSM HCFA 1500 Canadian Address Claim Form”)
  6. BCNMICAN – (Project Documentation: “BCBSM HCFA 1500 Canadian Address Claim Form”)
  7. HCFA-CAN – (Project Documentation: “HCFA 1500 Canadian Address Paper Claim Form”)
  1. Create Claim Styles
  2. BCBSMCAN – (Project Documentation: BCBSM HCFA 1500 Canadian Address Claim Form p. 2)
  3. BCNMICAN – (Project Documentation: BCBSM HCFA 1500 Canadian Address Claim Form p. 3)
  4. HCFA-CAN – (Project Documentation: HCFA 1500 Canadian Address Paper Claim Form p. 2)
  5. Set up Insurance Carrier Maintenance for each Carrier the practice will submit paper claims to.
  6. Refer to the appropriate project document

BCBSM carriers - (Documentation: BCBSM HCFA 1500 Canadian Address Claim Form p. 3)

BCN carriers – (Documentation: BCBSM HCFA 1500 Canadian Address Claim Form p. 3)

Medicare carriers – (Documentation: HCFA 1500 Canadian Address Paper Claim Form p. 2)

  1. Let Nancy Hannon in QA know which clients are using these custom crystal reports.

Revised: 12/16/03p. 1HealthMatics Ntierprise