Submitting claims to TELUS eClaims requires a 'Managing patient invoices' permission on your account. You can check with the clinic manager to see if you have such permission.
A predetermination claim allows you to submit a "mock" claim to check a patient's coverage eligibility before a service is rendered. There are 2 ways to submit a predetermination claim on Embodia:
- You can submit a predetermination claim from the patient profile, not associated with a patient invoice; or
- You can submit a predetermination claim from a patient invoice.
Predetermination claim not associated with an invoice
From the patient profile page, click on Billing > TELUS eClaims.
To initialize a predetermination claim, click on New predetermination claim. In the popup form, complete the required information. Once the basic information has been added to the claim page, you can add all the services/products that are part of this claim.
Click on Add an item, and fill out the popup form with:
- The service/product type;
- The quantity: this value should be in minutes for services and the number of items for a product;
- The price/cost of the service or product.
Once all the items have been added and you are ready to submit the predetermination claim to TELUS, check that you agree to the terms and conditions and that you obtained the authorization and consent from the patient, and then click on Submit to TELUS eClaims.
This will submit the claim to TELUS, and within a few seconds, the insurer's response will be displayed.
Predetermination claim associated with an invoice
From the patient invoice page, on the right-hand side, click on New predetermination claim.
In the popup form, complete the required information. Once the basic information has been added to the claim page, you can now add all the services/products that are part of this claim.
Click on Add an item, and fill out the popup form with:
- The associated line item from the invoice;
- The service/product type;
- The quantity: this value should be in minutes for services and the number of items for a product;
- The price/cost of the service or product.
Once all the items have been added and you are ready to submit the predetermination claim to TELUS, check that you agree to the terms and conditions and that you obtained the authorization and consent from the patient, and then click on Submit to TELUS eClaims.
This will submit the claim to TELUS, and within a few seconds, the insurer's response will be displayed.