Updated: April 13th, 2020 (see non-residents below)
To minimize the risk of COVID-19 virus spreading, the Ministry of Health in Alberta (AHCIP) is amending and activating Health Service Code (HSC) 03.01AD. The amended description of 03.01AD will read:
Telephone advice to a patient or their agent (agent as defined in the Personal Directives Act) during a viral epidemic.
By adjusting 03.01AD it helps ensure that patients and physicians are self-isolating while still receiving care. 03.01AD is available to bill and you can start submitting claims for immediately. It will remain active until as long as the Chief Medical Officer of Health determines it should remain active.
When can you submit claims for HSC 03.01AD?
03.01AD can be used to bill for providing advice via telephone, email, and videoconference including virtual care:
Whenever you provide care in relation to COVID-19.
Whenever you provide care for other conditions and either
a. You are in self-isolation
b. Your patient is in self-isolation
There is no cap on the number of claims you can submit. However, 03.01AD may only be claimed once per patient, per day.
03.01AD can be billed from all facilities (e.g. office, home, hospital etc.).
Restrictions & Guidelines
Email and videoconference systems must be in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service acceptable to the Office of the Privacy Commissioner of Alberta.
Regular landlines and cell phones can be used to provide advice.
You can only claim 03.01AD once per patient, per day.
It includes advice, providing a new prescription or prescription renewal.
You need to leave a note in the notes section of the claim documenting what the request/advice was.
You can only claim it when there’s communication between you and the patient or their agent.
You cannot claim 03.01AD when giving general information about COVID-19 virus.
You cannot claim it for any services provided through Health Link.
The Schedule of Medical Benefits is currently being updated to reflect the amendments, and will be published as soon as possible.
Appropriate Diagnostic Codes: 079.82
To help with monitoring, AHCIP is asking that you use ICD Code 079.82 or 079.8 (if restricted by claim submitter software) on all claims related to COVID-19 (even if your patient doesn’t have COVID-19 but they consulted you for symptoms).
For more information on the changes please see the original message from AHCIP.
If, at any time, you have any questions regarding 03.01AD or anything else please don’t hesitate to get in touch. We’ve extended our support hours and are here to help.
COVID-19 Billing Process for nonresidents of Canada.
Effective immediately, when submitting a claim to Alberta Health for the COVID-19 diagnosis and/or treatment of COVID-19 for a non-entitled non-resident of Canada, you need to follow the following process.
On the claim:
Enter the appropriate Health Service Code
Add the COVID-19 diagnostic code (diagnostic code 079.82 or 079.8).
Attach a person data segment and enter the personal information collected from the patient, including their name and the address in Alberta where the patient is staying.
Prior to submitting a claim under the COVID-19 billing process, you must verify insurance eligibility to determine that the patient is a non-entitled non-resident of Canada.
For a complete guide on how to submit claims for refurbishment in Alberta check out our Alberta Health Billing Guide.
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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