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eClaims

Using eClaims from your practice management software.

This resources centre is for healthcare professionals submitting claims through a practice management software.
If you submit claims through the eClaims portal, click here.

From learning how to submit claims and receiving payments to promoting eClaims to your patients, and getting one-on-one training – it’s all here.




Available from these practice management software solutions:





Ready to set up eClaims with your practice management software solution?

If eClaims is integrated with your PMS and you want to start using the integration, visit this page to know where to find the information you will need to set it up.

Learn more


Customer success story

Helen Tennant

While eClaims and Jane are great on their own, together they help clinics save time, streamline workflows and improve patient experiences. Learn how the integration helped the Tonume clinic.

Read the success story

Getting started

Become familiar with eClaims and how it can work for you. Section 1

Get all the info you need to be ready to submit your first claim. Section 2

Sign up for direct deposit to get paid faster and avoid unnecessary trips to the bank.
 
Section 3

Manage changes to your profile including new providers, new users, and address changes to ensure your profile reflects your evolving practice. Section 4


Submitting claims for virtual consultations with eClaims

Access our portfolio of resources to determine which insurers cover virtual consults, which types of services are covered, frequently asked questions, helpful links and articles and more.
Virtual consultation resources



Understanding insurer responses and software vendor error messages.


Understanding insurer responses

When you submit a claim, you can receive one of three responses from the insurer. Here are our recommendations for each type of response:

  • An “Explanation of Benefits” means the claim was processed.
    • It provides the response to your claim (accepted or rejected), and the amount that will be paid by the insurer.
    • Based on the amount that will be paid and who the payment recipient is, you will know what outstanding amount is owed by your client.
  • If the insurance company has received the claim request but is unable to process it, a Claim Acknowledgement is generated.
    • When you receive an acknowledgement or “Claim pending” response, we recommend you void the claim, collect the full amount owed from your client and either provide them with a receipt so they can submit the claim themselves or resubmit the claim and select “Payable to: patient” to avoid any payment follow-ups on your end.
  • Error means that either the eClaims system or the insurer’s adjudication engine is not functioning properly at the time you submitted.
    • When you receive an error message, we recommend you collect the full amount owed from your client and provide them with a receipt so they can submit the claim themselves.

We recommend you save a copy of the insurer’s response right away as it is only available on the day the request was submitted.


Software vendor error messages


Error -17: Unable to authenticate the user. Incorrect Password error

Please make sure the username matches the information provided in the spreadsheet for software vendor.

The password expires every 120 days, there is no prompt or warning. Best practice is to setup a calendar reminder for each user.

The provider must reset their password via TELUS Provider portal, if the password already expired they must call the TELUS Service Desk.


Error NL20: The Provider (Author) is invalid; not registered for TELUS eClaims or is unauthorized for the User.

This error means the provider details configured in the PMS do not match the information in the eClaims database.

Please review the information from the Spreadsheet to confirm all details (first and last names, license number, license issuer and roles) are correctly setup.

If there is an error in the spreadsheet provided by TELUS. The provider must submit a change request.


NL23; the servicing provider role is not registered for the TELUS eClaims service.

Please check that the correct provider role was selected and is mapping to the correct role code according to the table on the POS_VIG, chapter 6, tab “HealthcareProviderRoleType”

Example: if a provider has two licenses: one as an RMT and Physiotherapist, please make verify that when the Physiotherapist license is selected, TELUS receives Role Code: PHYSIO instead of RMT.



LENLONG – Policy or Member ID value has exceeded the amount of characters permitted.

Most policy numbers are usually 6 digits long.

Member IDs are usually 10 digits long, you do not have to enter the leading zeroes. However, please check the patient’s benefits card to validate both fields were entered correctly.

If all info is correct, please contact the insurer directly.

eClaims Integration Support Document November 2019


NL37; the insurer does not allow electronic submissions for this policy or group.

There might be a restriction on the patient’s plan to not allow electronic submission or payment assignment (allow the provider to receive payment on the member’s behalf), please have the patient contact the insurer/plan administrator directly to confirm and if possible, to remove the restriction.



FAQs

Have a question about submitting claims?

Check out our FAQs


Understanding the payment process.

Jennifer Hancock, Student Optician

As the statements of payment arrive, they should be reconciled as soon as possible. You want to process claims and reconcile payments quickly because you do not want anything to expire.

Jennifer Hancock, Student Optician
Cowan’s Optical
Mount Pearl, Newfoundland

Jennifer Hancock, Student Optician

The instant insurer response helps you deal with any issues with the patient in front of you which saves you a lot of hassle and frustration.

Christina Worm, RMT
Rejuvenating Massage Therapy
Oakbank, Manitoba

Jennifer Hancock, Student Optician

We keep separate folders for each insurance company. We have a spreadsheet to record appointment dates, patient names, and what was paid based on the eClaims portal.

Dr. Donald R. Earle, DC
Bay Roberts Spine Clinic Inc.
Bay Roberts, Newfoundland

Jennifer Hancock, Student Optician

I recommend processing the claim when the patient is in the office in case there are any problems.

Lucas, Optometric Assistant & Office Manager
Goemans Optometry
Guelph, Ontario

5 ways to ease payment reconciliation

5 ways to ease payment reconciliation

Reconciling claim refunds from all participating eClaims insurers can be a challenge. We’ve shared some helpful payment reconciliation tips from providers, but here are some additional recommendations that we think you would find useful:

  • Submit claims right away - immediately after the treatment while the client is still with you.
  • Print or save all Explanation of Benefits statements so you can refer back to them during reconciliation, if need be.
  • Leverage the Past Transactions tab in the eClaims portal to download transactions from the past 31 days - this is your starting point for easy reconciliation.
  • Plan reconciliation activities in your agenda - integrate eClaims reconciliation into your monthly bookkeeping activities (make sure you do it at least every 30 days).
  • Download the eClaims insurer payment guide for a snapshot on payment details and contact information for each insurer. Payment questions should always be directed to the insurers.

Want to know when a payment will be issued or what the payment method will be?

Insurer payment guide

Ease payment reconciliation by tracking payments in one place.

Payment reconciliation template


Everything you need to know about submitting to participating insurers.

Select your profession and your province to access the information.

Promote eClaims to your clients.

Now that you offer eClaims as a value-added service to your patients, let them know!

Click here for details


Webinars

3 marketing essentials to help jumpstart your practice.

Submitting claims for virtual consultations with eClaims.

5 tips to help you get more out of eClaims. Full video

Payment reconciliation : tips to optimize the process. Full video




Articles

Back on track: Will employers fund allied healthcare?

The long-term impact of the coronavirus pandemic will not be known for months, or possibly years, but its immediate aftermath is being felt at many levels. Will patients be back? Will employers still provide coverage? Can we rebuild with streamlined practices for a new world of healthcare delivery?

Read the article


Tips to make the most out of virtual consultations.

As a new normal of physical distancing takes hold, many allied healthcare professionals are treating their patients virtually. While virtual consultations can be just as effective as in-person appointments, they may be a little daunting at first. As with most things, preparation is key. Here are a few tips to help ensure your time is focused on the patient, not technology.

Read the article

Getting started
Submitting claims
Payment information
Insurer information
Promote eClaims
Webinars

Getting started Submitting claims Payment information Insurer information Promote eClaims Webinars