Publications

Hospital reciprocal claims guide

Description

This manual provides Alberta hospitals and health zones with a reference document outlining the policies, guidelines and processes for interprovincial/territorial hospital claims for insured... More ≫

Description

This manual provides Alberta hospitals and health zones with a reference document outlining the policies, guidelines and processes for interprovincial/territorial hospital claims for insured in-patient and outpatient hospital services.

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Alberta Health Care Insurance Plan : Schedule of Medical Benefits as of 01 April 2024

Description

The Schedule of Medical Benefits, or SOMB, contains the fee schedule and list of medical benefits insured under the Alberta Health Care Insurance Plan, and the rules that govern billing.

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Immunization and adverse reactions following immunization (Imm/ARI) : permissible values

Description

This document, also known as the Immunization Data Standard Code Tables, provides guidelines for the electronic submission of immunization data to Alberta Health. It outlines the permissible... More ≫

Description

This document, also known as the Immunization Data Standard Code Tables, provides guidelines for the electronic submission of immunization data to Alberta Health. It outlines the permissible values for various data elements required for submission, ensuring compliance with established business rules and program validation rules specific to Alberta's immunization programs and the Alberta Immunization Regulation. Organized in a systematic manner, the document includes essential data elements required to minimize data rejections and errors due to incorrect or improper data structure and format.

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Immunization batch data submission and response guidelines

Description

This document defines the requirements for the electronic submission of immunization data to Alberta Health. Adherence to this document will ensure minimal data rejection due to incorrect or... More ≫

Description

This document defines the requirements for the electronic submission of immunization data to Alberta Health. Adherence to this document will ensure minimal data rejection due to incorrect or improper data structure and format. In addition to the business rules identified in the data submission and response guidelines, there are program validation rules specific to the immunization programs established in Alberta. A comprehensive listing of all program validation rules that should be adhered to may be found in this document.

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Allied health practitioner’s resource guide

Description

The purpose of this guide is to help allied health practitioners (dental surgeons, optometrists, podiatrists) and their billing staff prepare claims for services that are insured under the Alberta... More ≫

Description

The purpose of this guide is to help allied health practitioners (dental surgeons, optometrists, podiatrists) and their billing staff prepare claims for services that are insured under the Alberta Health Care Insurance Plan (AHCIP), and follow up, if necessary, after claims have been assessed. The information in this guide will help users: understand what must be included on all claims to the AHCIP; ensure that data entered on a claim is up-to-date; verify a patient's health care coverage; and understand the Alberta Health Statement of Assessment and Statement of Account. This guide is designed for use in conjunction with the Schedule of Benefits.

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Physician’s resource guide

Description

The purpose of this guide is to help physicians and their billing staff prepare claims for services that are insured under the Alberta Health Care Insurance Plan (AHCIP), and follow up, if... More ≫

Description

The purpose of this guide is to help physicians and their billing staff prepare claims for services that are insured under the Alberta Health Care Insurance Plan (AHCIP), and follow up, if necessary, after claims have been assessed. The information in this guide will help users: understand what must be included on all claims to the AHCIP; ensure that data entered on a claim is up-to-date; verify a patient's health care coverage; and understand the Alberta Health Statement of Assessment and Statement of Account. This guide is designed for use in conjunction with the Schedule of Medical Benefits.

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Alberta Health Care Insurance Plan : Schedule of Medical Benefits as of 23 October 2023

Description

The Schedule of Medical Benefits, or SOMB, contains the fee schedule and list of medical benefits insured under the Alberta Health Care Insurance Plan, and the rules that govern billing.

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Alberta Health Care Insurance Plan : schedule of medical benefits as of 01 April 2023

Description

The Schedule of Medical Benefits, or SOMB, contains the fee schedule and list of medical benefits insured under the Alberta Health Care Insurance Plan, and the rules that govern billing.

Tags

Camrose Primary Care Network

Description

Offers an overview of the current health status of patients in the Camrose Primary Care Network, indicators of the Network's current and future health needs, and evidence as to which quality... More ≫

Description

Offers an overview of the current health status of patients in the Camrose Primary Care Network, indicators of the Network's current and future health needs, and evidence as to which quality services are needed in a timely and efficient basis to address these needs. One in a series of profiles created to assist Alberta's 40 primary care networks with primary health care planning by providing a broad range of demographic, socio-economic and population health statistics considered relevant to primary health care for communities across the province.

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Cold Lake Primary Care Network

Description

Offers an overview of the current health status of patients in the Cold Lake Primary Care Network, indicators of the Network's current and future health needs, and evidence as to which quality... More ≫

Description

Offers an overview of the current health status of patients in the Cold Lake Primary Care Network, indicators of the Network's current and future health needs, and evidence as to which quality services are needed in a timely and efficient basis to address these needs. One in a series of profiles created to assist Alberta's 40 primary care networks with primary health care planning by providing a broad range of demographic, socio-economic and population health statistics considered relevant to primary health care for communities across the province.

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