Troubleshooting Questions
1. Has anyone successfully billed through this POS in the past?
If no, is the POS setup correctly with Teleplan?
- Check the POS information in the "List of POS's & Payee ID's" under the Overview section.
- Some POS's are not set up for billing.
- Providence Health Care (PHC) POS's may be linked to the PHC Teleplan Data Centre # instead of the VCH Community Teleplan Data Centre #, in which case they cannot bill through our implementation of Profile EMR (because it uses the VCH Community Teleplan Data Centre #, and also because a Payee ID (or MSP #) cannot be linked to more than one Teleplan Data Centre #).
- Specialty Clinic POS's may also have unique features (Serina?).
2. Has this clinician successfully billed in the past?
a. If yes, has the clinician successfully billed through this POS in the past?
i. If yes, is the clinician's MSP # entered correctly on the Reference and Member Of screens?
ii. If yes, has anything about the Payee ID the clinician is using for this POS changed?
b. If no:
i. On the clinician's Financial screen, is the "Is Financial" setting checked, and the "Hold Claims" setting unchecked?
ii. Is the clinician setup correctly with Teleplan?
3. Is a Locum involved?
4. Is it a claim creation issue?
a. On the clinician's "Financial" screen is the "Is Financial" setting checked?
b. On the clinician's "Member Of" screen is the "Create Claims" setting for this POS set to "Never" or "On Attendance"?
5. Is it a claim submission issue?
a. Is the clinician correctly setup for billing at this POS?
b. Does the client have a BC PHN?
c. If the clinician is an NP, is Service an eligible NP Service Code?
d. Does the claim contain at least one ICD-9 Diagnosis Code?
e. Is the claim Location set to "B - Community Health Centre"?
6. Is it a billing reconciliation issue?
a. Is the claim Location set to "B - Community Health Centre"?
See the "Billing Reconciliation Issues" section below.
Claim Submission Issues
| Code | Message | Troubleshooting |
| Reference 2 in alias MSP is not valid | Clinician’s MSP # is missing or incorrect | |
| Alias MSP for referrer clinician is not found | The text in the Referral field must be deleted | |
| Diagnosis 1 field cannot be empty | Clinician must add at least one ICD-9 diagnosis code | |
| Only financial users can bill services | "Is Financial" is not checked | |
NP Service Codes
NP's can only submit claims with the following MSP Service Codes:
|
Code |
Description |
|
97566 |
Virtual NP Consultation: Video |
|
97567 |
Virtual NP Visit: Video |
|
97568 |
Virtual NP Counselling: Video |
|
97569 |
NP Telephone Services with Provider |
|
97573 |
Virtual NP Consultation: Telephone |
|
97574 |
Virtual NP Visit: Telephone |
|
97575 |
Virtual NP Counselling: Telephone |
Teleplan Access Issue
Sometimes when a CSC tries to submit claims, they are asked to login to Teleplan:
Before contacting the SA Team, try the following.
This message can appear when the Teleplan server is busy, so try again later, or try earlier in the day when the server is often less busy.
To determine whether there is a problem with Teleplan access, on the Control Centre - Billing screen perform a client verification on a client with a green checkmark. If the verification is successful, Teleplan access is working and the problem may be that the server was simply busy when the user tried to access it.
If the client verification fails, then contact the SA Team and ask them to check the password or to contact Teleplan.
Billing Reconciliation Issues
Many users consider reconciliation the most difficult part of the billing process. One reason is Teleplan has many different codes for rejecting claims.
Known Exception Error Message
When users are trying to resubmit a refused claim by selecting Resubmit or Write-off the below exception error appears. The error occurs after the resubmit process completes and the form attempts to reload the changed data. IH has confirmed that this is a bug and it does not affect the submission to Teleplan.
When OK or Close is selected the claim is resubmitted.
MSP Explanatory Codes
For a complete list of MSP Explanatory Codes, see :
|
Code |
Description |
Troubleshooting |
| *A | OUR RECORDS INDICATE PATIENT DECEASED. PLEASE CONTACT MSP. |
|
| *B | PATIENT'S ELIGIBILITY WITH MSP IS IN QUESTION. PLEASE HAVE PATIENT CONTACT MSP. |
|
| BG | AMOUNT ADJUSTED TO THE RATE EFFECTIVE FOR THIS DOS. |
|
| BH | THIS CLAIM WILL BE PROCESSED ON A FUTURE REMITTANCE STATEMENT. PLEASE DO NOT REBILL. | |
| BV | SERVICE DATE EXCEEDS ALLOWABLE CLAIM SUBMISSION PERIOD. | |
|
CK |
PRACTITIONER NUMBER IS INVALID FOR THIS PAYMENT NUMBER AND DATE OF SERVICE. |
Clinician must complete Form #2870 ("Assignment of Payment Due to Practitioner Under the Medical Services Plan") every five years |
| I8 | ANOTHER PHYSICIAN HAS CLAIMED 00039 - MANAGEMENT OF OPIOID AGONIST TREATMENT (OAT) DURING THE SAME TIME PERIOD. REBILL WITH ADDITIONAL INFORMATION. | |
| QP | REPEAT/STAGED PROCEDURES ARE NOT PAID WITHIN DESIGNATED TIME LIMIT. | |
|
W2 |
DATA CENTRE AND PAYEE NUMBER COMBINATION NOT ON FILE. |
Clinician has not linked their MSP # to the Vancouver Community Data Centre # |
| X2 | FACILITY NUMBER IS MISSING OR INVALID | Likely a problem with the MSP # or Payee ID, or the required MSP Teleplan Forms have not yet been completed. |
| X9 | RCP ADDRESS MISSING OR NOT SHOWING IN LINE ONE | Out-of-province claims must include the patient’s PHN, full name, gender, dob and full address (including postal code). |
| YY | PRE-EDIT SYSTEM REFUSAL. SEE SECOND EXPLANATORY CODE(S). |
|
|
Y4 |
SERVICE LOCATION CODE MISSING OR INVALID. |
Claim location must be set to “B - Community Health Centre” |