Give your patients another reason to choose your services.

Simple Group Benefits Billing Software

Registered with eClaims? Get your eClaims account integrated into Claim Manager for truly simple billing experience. Bill group benefits plans, provincial plans and patients with one software. For allied health professionals and optometrists in Canada.

Three lifesaving reasons to do all your billing in one place.

Literally. Get your life back.

Three reasons to bill group benefits plans with Claim Manager.

1. Bill group benefits and public plans at the same time

Include B.C. insurance plans in your billing.

Claim Manager

Other Software

MSP
ICBC
WorkSafeBC
Pacific Blue Cross
Standard Life Assurance Company of Canada

Johnson Inc.
Cowan Insurance Group
Industrial Alliance
Chambers of Commerce Group Insurance Plan

Desjardins Insurance
Manulife Financial
Canada Life
Maximum Benefit or Johnston Group

2. Coordinate group benefits with provincial plans

Check provincial benefits to comply with coordination of benefits rules.

Claim Manager

Other Software

Coordinate MSP and group benefits

Instant check of MSP benefit is built into every claim. The group benefits claim is decreased by its amount.

Coordinate ICBC and group benefits

Each ICBC claim is validated. Any balance not covered by the claim is billed to the group benefits plan.

3. Bill many payees at once

No need to switch between software when billing multiple payees.

Claim Manager

Other Software

Bill several payees in one transaction

Bill MSP fee to MSP, the balance to the group benefits plan and the remainder to the patient – all in one transaction.

Get aggregate income reports

Keep all transactions in one database. Prepare income reports across all payees and any time periods.

Bill all payees with one software

Bill MSP, WorkSafeBC, ICBC, extended health plans and patients with one software.

Bill several payees at once

Bill MSP fee to MSP, the balance to the private plan and the remainder to the patient – all in one transaction.

Get aggregate income reports

Keep all transactions in one database. Prepare income reports across all payees and any time periods.

HEALTH CARE SERVICE: EXAMPLE

Service fee $100.00 = MSP benefits $23.00 + group benefits $70.00 + out-of-pocket $7.00
OPTOMETRY SERVICE: EXAMPLE

Service fee $100 = MSP benefits $46.17 + group benefits $43.06 + out-of-pocket $10.77
PHYSIOTHERAPY SERVICE: EXAMPLE

Service fee $100 = ICBC benefits $25.20 + group benefits $59.84 + out-of-pocket $14.96

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

Real-Time Claims’ Adjudication

Most insurance companies provide Explanation of Benefits (EOB) as soon as you submit a claim, so that you know right away how much the insurance will pay.

Instant EOBs

Learn the amount of benefits in real time.

Easily manage EOBs

Access past EOBs at any time
Provide a copy on patients’ request
Void if submitted in error*

*when supported by the insurer

Need more reasons to join Claim Manager?

Claim Manager autocompletes the claim.

Simply check it and fill in any gaps.

Auto-fill patient profile

Use patient lookup instead of filling profile by hand – even for occasional patients.

Claim Manager

Other Software

Select from the clinic’s index

Fill in the patient and insurance-holder profiles using the patient lookup.

Select from the MSP Index

Fill in profiles of new patients using the MSP integration lookup.

Handle spelling mismatch

Auto-fill the right spelling when it differs on public and private plans.

Auto-fill service details

Don’t bother entering service details into the claims.

Claim Manager

Other Software

Default service

Use default initial service to auto-fill the first claim of a new patient.

Predictive autocomplete

Use predictive auto-complete to fill in the service details for return patients.

Custom price list

Use service lookup to change the service details with one click.

Auto-fill authorization forms

Print ready-to-sign authorization forms.

Claim Manager

Other Software

Electronic Transmission Authorization form

A patient must sign the ETA form for every insurer. CM alerts you and completes the form.

Benefits Assignment form

A patient must sign the BA form to decrease the upfront payment. CM alerts you and completes the form.

Claim Manager preserves your data.

Access your data at any time.

Your data is stored while you need it.

Claim Manager

Other Software

Preserved insurance accounts

Do not ask your patients to repeatedly show their insurance cards. Store insurance accounts in Claim Manager.

Detailed explanations of benefits

Need to address inquiries or solve disputes? Access explanations of benefits at any time.

Complete billing history

Access complete billing history to reconcile payments, prepare income reports or comply with audits.

CM turns predetermination requests into claims.

Do twice the work in half the time.

Create a predetermination request (PDR) and a claim with one form.

Claim Manager

Other Software

A PDR is a claim sidekick

Each claim comes with a PDR if supported. Get an estimate of benefits before billing.

Convert PDRs into claims

Convert the approved PDR into a claim for instant processing instead of creating a new claim.

Convert PDRs into invoices

Convert the declined PDR into a patient invoice instead of creating it from scratch.

Spend time on what you love. Leave billing to us.

SO SIMPLE

You can do your billing yourself.

Try it today. Limited time offer.

14-DAY FREE TRIAL!

F.A.Q. About eClaims Integration

Read this section if you have more questions about eClaims and Claim Manager integration.

Claim Manager and eClaims

How did TELUS Health revolutionize medical billing for health care providers?

Do you remember the times when only Canadian dentists could bill group benefits plans electronically? Your patients had to do it themselves. By mail! A new standard of customer care was brought about by TELUS Health. It introduced eClaims, a Canada-wide electronic group-insurance-billing system for health care practitioners. eClaims enabled physiotherapists, acupuncturists, massage therapists, chiropractors and other providers to submit private insurance claims on their patients’ behalf.

How does eClaims work?

How do practitioners communicate with eClaims Switch?

eClaims Switch Web service is a black box that does not have a user interface. It operates with encoded data that is not legible for humans. People need a user interface to communicate with eClaims Swtich Web service. Practitioners can select software with the best user interface. The choice of that software is important because the set of its features will determine the convenience of group benefits billing and payment reconciliation for the clinic’s staff.

What user-interface software is available to users of eClaims Switch?

eClaims portal by TELUS Health provides a basic user interface to eClaims Switch Web service. The eClaims portal consists of a set of webpages for data entry and review that retains records for a limited time. All entered data is eventually purged because eClaims is not connected to any practice management software.

A more advanced and convenient user interface is provided by Claim Manager. Claim Manager seamlessly integrates group benefits billing into your practice management software and uses its information to auto-complete your claims. It also stores all group benefits claims and explanations of benefits in your practice management software so that you can prepare your financial statements and analyze your revenues at any time. The integration with your practice management software allows Claim Manager to provide features that are not available in a stand-alone billing applications such as eClaims.

Why integration with my practice management software is a big deal?

The patients love when you deal with their insurance, but the health care providers see it as extra work and no pay. Integration of group benefits billing into your practice management software eliminates that extra work. When you are using a stand-alone group benefits software, such as eClaims, you have to log in and enter patients’ information and service details. Then you have to switch to your other billing software and do it all over to issue a patient invoice or create a provincial insurance claim. Doing all your billing in your practice management software eliminates repetitive work and keeps you and your patients happy.

When would I need to bill multiple payees at once?

Many patients are covered by both provincial and group benefits plans with balance paid by the patient, so one service might require up to three billing transactions. Creating such transactions individually is like servicing three different patients. To save your time on such patients, use Claim Manager. Claim Manager will bill all three payees in one transaction, rolling over the balance among payees until it is paid in full.

The complete list of Claim Manager's features

Why Claim Manager is worth every penny

Features
Claim Manager
Other Software
Coordination of Benefits with Provincial plans
In BC
No
Practice Management Software
Yes
No
Data retention
All data
A maximum of 2 months of data: current month + 1 month prior; data purged at the beginning of each month
Search for a patient
Any time
Only during data retention
Search for a transaction
Any time
Only during data retention
View transaction details
Any time
Only on the day it was created; only summary view is available next day; no view is available after data retention period.
Saving Payment and Predetermination requests as drafts for submission at later time
Yes
Only until the end of the day
Predetermination responses are stored and turned into claims
Yes
No
Income reports for custom time periods
Yes
No
Payment reconciliation reports for custom periods
Yes
No
Patient billing history reports for custom periods
Yes
No
Claim autocomplete
Yes
No

Claim Manager integration is tested and approved by TELUS Health.

Coordination of Benefits

If the patient is covered by multiple insurance plans, the benefits must be coordinated between them.

Do I bill MSP or the group benefits first?

A practitioner must bill the provincial insurance plan before billing the group benefits plan. For an MSP Premium Assistant patient, for example, a practitioner must bill $23 to MSP and the remainder to the group insurance. Each claim contains a mandatory field, where practitioners must indicate if the provincial health care plan is exhausted. Therefore, billing of the provincial plan is an integral part of private insurance billing. Claim Manager verifies MSP eligibility for each patient before creating a group insurance claim.

Can I bill secondary insurance plan with eClaims?

Currently eClaims only allows you to bill the primary group insurer, with the secondary insurance information being included in the claim. That informs the primary insurer about the need to coordinate the benefits with the secondary insurer. If your patients participate in two insurance plans, they have to submit the claim to the secondary insurer themselves. They might be asked to enclose the explanation of benefits provided by the primary insurer.

Do I bill ICBC or the group benefits first?

If the patient has a group insurance, ICBC may refuse to pay for the treatments until the patient exhausts the group insurance coverage. Section 88 (6) of Part 7 of the Regulation reads that ICBC “is not liable for any expenses paid or payable to or recoverable by the insured under a medical, surgical, dental or hospital plan or law, or paid or payable by another insurer.” However, ICBC adjusters rarely enforce this condition, so most practitioners can successfully collect ICBC benefits before billing group insurance plans.

The practice in B.C. is to bill the service to ICBC first and the balance, if any, to the group benefits plan. In your group benefits claim indicate that the claim is related to the motor-vehicle accident. After the patient settles the claim with ICBC, the patient might be required to reimburse the group benefits plan for the benefits paid in relation to that claim.

You must enroll in eClaims to have it integrated in Claim Manager.

Enroll with eClaims Today

Not enrolled with eClaims? Do it today. Share the benefits of technological progress with your patients.

Estimate the group insurance benefits

Some insurance companies provide an estimate of benefits on a practitioner’s request. Such a request is called a predetermination request. The predetermination response shows the amount of benefits that would be paid if the service were to occur on the date of request. Predetermination request allows patients to estimate the out-of-pocket expense for their services. Practitioners can use the requests to help patients to budget for their treatment plans.

Get real-time explanations of benefits from group insurance plans

What if the immediate explanation of benefits is not available?

If an immediate explanation of benefits is not supported, the insurer provides an immediate Acknowledgement response to confirm the receipt of the claim. The Explanation of Benefits is sent to the payee at a later date by regular mail. The acknowledgment creates uncertainty because the amount of benefits is not declared. We recommend that you indicate the patient as the payee of the benefits in such claims and bill the full amount to the patient. The patient will collect whatever is paid by the plan.

Have insurance benefits paid to the practitioner

Receive insurance benefits directly to your bank account

Have more questions?

How to register with eClaims