Good faith, newborn and reciprocal claims

Three patients who don't fit the form

• 9C · Good Faith. You couldn't confirm their identity through AHCIP and saw them anyway. The claim goes out flagged in good faith, the health number is deliberately blank on the claim record, the good-faith indicator is set, and the patient's identity travels on a separate segment — because Alberta Health expects it to.
• 9D · Newborn. The baby has no personal health number yet. The parent's number carries the claim in its own field, and the card stays blank until Alberta Health issues the baby's own on the assessment.
• 9A · Medical Reciprocal. An out-of-province patient. Their reciprocal registration number rides on the claim in place of an Alberta health number, with the recovery code for their home province, and the referring doctor's details go where Alberta Health expects them. Quebec is excluded — it does not take part in the reciprocal arrangement — so the software says so rather than filing something that will bounce.

The standard case

A valid nine-digit provincial number is checked for structure before the claim is built rather than after Alberta Health rejects it; if it fails, the message says which record to look at.

It argues with you before it sends

Missing billing identifiers, a province that isn't Alberta with no reciprocal registration, a visit that already has a submitted claim — all of it surfaces on the encounter while you can still do something about it.

Where to look

• Alberta clinics — three patients who don't fit the form · The EMR — the claim