Creating Claims

There are three ways to create a claim:

1. Automatically (when an appointment is booked or when the client arrives)
2. In the main menu or toolbar, by clicking "Quick Bill"
3. On the Billing screen, by clicking the "Add" button

Most clinicians use a combination of all the methods, with most claims created automatically or with "Quick Bill" throughout the day, and then with the Billing screen at the end of the day to ensure no claims were missed and all claims are completed.

Automatically Creating Claims

Claims are automatically created when the clinician's "Create Claims" setting is "On Appointment" or "On Attendance". The other option for this setting is "Never", in which case claims are not automatically created.

For clinicians who work at multiple POS's, this setting can be set differently for each POS.

"On Appointment" means a new claim is created whenever the clinician has an appointment booked. (This setting is rarely used.)

"On Attendance" means a new claim is created whenever the clinician has a client marked as Arrived for an appointment. (This setting is often used, especially for NP's.)

This setting is on the Clinician "Member Of" screen.

"Quick Bill"

While in an encounter, click the "Quick Bill" button in the toolbar or under the Financial menu, and a new claim is created based on the current encounter.

If the encounter has a Diagnosis (problem) as its title, that Problem is automatically entered in the Diagnosis 1 field.

Billing Screen

On the Billing screen, click the "Add" button and then select the client.

Completing the Claim

Once the claim is created, the clinician must ensure all necessary information is entered or it will be rejected and will need to be corrected and resubmitted.

PHN

The claim must have a PHN. Normally it will be a BC PHN, but it could be an out-of-province PHN (note, if it is an out-of-province PHN, the client record must contain a full name, gender, date of birth and full address including postal code or the claim will be rejected by MSP).

Location

The location must be "B - Community Health Centre".  (It currently still defaults to "Practitioners Office - In Community" but until the next release of Profile EMR is available this must be changed by the user.)

Service Code

This defaults to one of the "0100 VISIT IN OFFICE" codes and does not need to be changed, unless:

• The clinician is an NP, in which case see attached NP Encounter Codes from PCN Compensation ([e-mail]) on 2Apr2026 attached
• The claim is for completion of a Disability Form
• The claim will be paid by a Payer other than MSP (e.g. WCB or ICBC), in which case enter "WCB" or "ICBC" in the Service field and select the appropriate Service Code (note, these non-MSP claims are still submitted through the MSP Teleplan system)

2Apr2026: NP Encounter Codes from PCN Compensation ([e-mail]) attached.

Diagnosis Code

If the claim is being submitted to MSP, it must contain a valid ICD-9 diagnosis code.

Click the ellipsis on the right side of the Diagnosis 1 field to display the Disease Code Assistant screen  and select the checkboxes at the bottom of that screen to display the client's diagnoses and then select a diagnosis.

Up to three diagnoses can be entered if necessary.