ICBC Claims Process By Jason Tutt, R.Ac.

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In order to address inquiries sent to the College about the ICBC claims process, this article provides registrants with the fundamentals on how to find further information and where to direct your questions, comments and concerns.  

 

1.Where should you look for more information about the ICBC claims process?

ICBC has a designated Health Services page on their website to provide healthcare providers with information on the ICBC claims process. This is the first place all BC health service providers should look for the latest news and updates.

 

When information is needed regarding claiming and reporting for Acupuncture services specifically, health service providers should additionally look at ICBC’s Acupuncturists page listed on the right side of the Health Services page. It summarizes ICBC’s treatment guidelines and fee schedule for Acupuncture services.

 

Finally, and with respect to auto insurance claims in particular, health service providers should read ICBC’s Questions and Answers for Health Care Providers document. This document can also answer questions your patient may have about the claim process.

 

2.Where should you look if you want information on how to start direct billing for ICBC claims?

ICBC also has an Invoicing and Reporting page on their website with everything health service providers need to get setup with ICBC for the direct billing of claims related to traffic injuries. The billing process for ICBC is similar to that for billing extended health benefits claims, such as with Blue Cross.

 

On this page you can apply for a vendor number (required to directly bill ICBC) as well as submit invoices using the Health Care Provider Invoicing and Reporting (HCPIR) application. You can also apply for treatment extensions. In order to use this application, you will need both your vendor number and the patient’s claim number.

 

3.Are there any resources for further clarification on obtaining a vendor number and using the Health Care Provider Invoicing and Reporting (HCPIR) application?

Yes! Visit the ATCMA website where you will find a designated ICBC page and three videos that walk registrants through the processes of applying for a vendor number, submitting an invoice using the HCPIR, and submitting a request for a treatment extension or a discharge notification.

 

ICBC has also created a detailed document that walks through the process of using the HCPIR application for acupuncturists and TCM practitioners.2  

 

Helpful Tips for avoiding mistakes during the ICBC invoicing process When submitting an invoice to ICBC using the Health Care Provider Invoicing and Reporting (HCPIR) application, you should note the following:

o Only the first treatment can be billed as “Assessment Visit”;

o All subsequent follow-up treatments are billed as “Standard Treatment”;  

o only one treatment can be billed for a patient per calendar day;

o The “Assessment visit” includes the first treatment and hence the first visit should not be invoiced both as an “Assessment visit” and a “Standard Treatment” to try to get more coverage for the visit.  

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• Invoices are to be submitted after you have seen your patient, but not before. This will avoid the need to process a reversal if the patient does not attend their appointment. Invoicing prior to appointment completion may result in delayed payment and challenges with reconciliation. • ICBC does not reimburse practitioners for “no shows”. The health care provider should invoice the patient directly for a “no show” as per your clinic’s policy. This is not an accident benefit that is payable by ICBC.  

• When submitting an invoice via HCPIR, enter the invoice number from your clinic management software or paper invoice into the “Invoice” field for easier payment reconciliation. For more information on how to facilitate your invoice reconciliation, refer to the HCPIR application checklist .

• Vendor numbers are required for health care providers that directly bill to ICBC. If a registrant works at multiple clinics billing patients directly and then reimbursing the practitioner, each clinic will need its own vendor number. If a practitioner works at multiple clinics but gets paid directly from the patient, then only one vendor number is required.  

 

4. Which ICBC department should you direct your inquiries about the ICBC claims process?  

ICBC’s Health Care Inquiry Unit is available to assist you with questions relating to the claims policies and process, HCPIR application, vendor number application, specific questions regarding your patients’ cases, such as treatment extensions.  

 

Hours: Monday-Friday, 8:30am-4:00pm PST

Lower mainland: 604-587-7150

Toll free: 1-888-717-7150  

 

Information for the article is provided by ATCMA. The ATCMA (BC Association of TCM & Acupuncture Practitioners) can be found at https://atcma.org and can be emailed directly at info@atcma.org (email correspondence can be answered in both English and Chinese).