The product

What the form knows before you type.

Premiums, read from the schedule

The claim form: macros, service lines, the premium column, and the lines on this claim

A fusion from a macro. One tap, four lines, every premium the schedule attaches, with the page.

The premium column reads the Schedule of Benefits the way it is written. After-hours procedure premiums from GP104, one per claim. Add-ons named under your codes with their chains one step ahead, E370 then E366. Add-ons offered by the scope their own words state, such as to any intracranial procedure, and by their position on the page. The trauma premium from GP109. Special visit travel and first person seen codes by setting and time from Tables I to X. Every button carries the page and the reason.

And your own remittances

Every premium paid with these codes in at least a quarter of your paid claims leads the column, with the count on the button.

A consultation claim with special visit premiums for a hospital visit after 17:00 — A consultation in hospital after 17:00.

The premium column searched for duroplasty, with matching add-ons from the schedule, their fees and paid counts — Search the whole schedule from the column.

Macros you never built

The macros column: code sets from paid claims, each named in plain words, with its codes, case count and last date

Every code set you have billed in your last 400 claims, labelled in plain words, counted, dated, starred to pin, searchable, and grouped as a stay is billed: procedures, then rounding, then discharge. Nothing is typed in. The codes and quantities are the lines as they were paid.

The stay, not the claim

The home page: cash position, amount billed this month, the submission deadline, and recent patients with the next rounding or discharge day

A rounding day billed from the home page, from the surgeon’s own pattern.

Recent patients appear on the home page with the reading of what was done and the next billable day: Day 1 rounding, Day 2, Discharge with a date to confirm. The pattern is yours, mined nightly from your paid claims. A procedure you almost always bill alone is recognised as day surgery and gets no rounding prompt.

A patient page listing every episode and every claim for one patient — One patient, every episode, every claim.

Know what you made

Procedures: episodes, submitted, paid, typical paid, length of stay, visits, rejections, days to payment, diagnoses and facilities

Accounting: received, billed and receivable this month, deposits, and a register of remittance allocations

Procedures: cases, billed, received, per case, average length of stay, visits, discharge share, rejection share, payment lag, pathology, facility. Accounting: this month, received, billed, receivable, deposits and a register from remittance allocations. CSV for your accountant and QIF for Quicken, with no patient identifier in either file.

The ministry link, done properly

The submit screen: claims selected to send, a submit control, and the recent submissions table

Remittances from the ministry, each row with payment date, payable, allocated, residual, claims paid and status

Claims go to the ministry through the MC EDT web service, with health card validation before you submit. A file is submitted once; if the outcome is unknown the application recovers with evidence or hands the decision to you. Remittances arrive as line-level allocations, every paid, adjusted and reversed line matched to its claim, and unmatched lines wait in a queue.

What it does not do yet

There is no human billing-agent tier.
Ontario only.
The mobile apps are built and not yet in the stores; the web application works on a phone.