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Reciprocal Billing in BC - the How To guide

How often do you get your reciprocal out of province bills bounced back by MSP? The vast majority of them? You're not alone. When you first start submitting out of province bills in BC, it can certainly be confusing as to what information is required. Fortunately, we can help!
First off, breathe. Out of province reciprocal billing isn't that bad, you just need to make sure you've got your ducks in a row.

How ClinicAid Can Help

We handle the majority of the Reciprocal Billing process automatically. If you have created a patient with a Health Care type outside of BC, when you bill the patient we automatically create the invoice as an out of province bill.

What you will need to do on your end to ensure that these payments go through is pretty simple, just make sure that you include the following patient information:

  • Birth date
  • Gender
  • Street address
  • Province
  • Postal Code

That's it. If you have those details entered in the patient demographic  once you add them to the invoice, their information is automatically filled into the necessary fields and you're done! Just save and send and watch the settled claims come rolling in.

One Caveat:

Our good friends out in Quebec are the one province that has held out from participating in the Inter-provincial Reciprocal Payment Agreement, therefore, any patient with a Quebec Health Card will have to be billed as a private/uninsured invoice for which the patient can get reimbursement from their province upon return.

The Nuts and Bolts:

Create your patient:

add a new patient window

 Click 'Show all fields' for the full patient demographic. Click 'Create patient' when you're done.

add a new patient all fields window

We automatically adjust the insurer type to Out of Province, and notice the Health Number is blank:

create invoice advanced tab

The Patient Demographic is fully populated with the patient's registration number, province, birth date, gender and address. Just add your service codes as per usual, and your new reciprocal bill is ready for processing.

reciprocal invoice patient demographic

For more information on Reciprocal Billing, the Ministry of Health has created this pdf with information on provincial health card numbers, as well as limitations on procedures that can be billed.

Do you split your time between BC and Alberta? Check out our Alberta Reciprocal billing guide!

If you have any other helpful tips, let us know, and we'll share with the rest of the community!

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