The Saskatchewan Ministry of Health's Medical Services Branch (MSB) is pleased to share that we are replacing our medical claims processing system. The project is currently underway and we expect to implement the new system in early 2023. The current medical claims processing system was installed in 1964 and no longer meets the needs of the Ministry or practitioners. The new claims system will provide a more modern platform for processing Saskatchewan medical claims and will improve our service delivery to practitioners.
As part of this project we will be replacing the current Internet Claims Submission site with a new Customer Portal which will provide practitioners with additional functionality such as:
- Log an inquiry related to a claim on the Customer Portal for Medical Services Branch (MSB) staff to receive.
- Practitioners can download forms from the Customer Portal.
- Receive batch claims either through your billing vendor or authorized service bureau. Billing clerk can log on to the Customer Portal and submit claims on your behalf.
- Paper claims can now be submitted on the Customer Portal.
To provide you with additional information, we have developed a Frequently Asked Questions section that we will continue to update throughout the lifecycle of the project.
Please feel free to reach out to MSBClaimsInitiative@health.gov.sk.ca if you have any questions.
1. Will physicians be able to continue to submit claims through their EMR billing software or are they going to have to submit via the new Customer Portal?
We are currently working specifically with the Accuro vendor to ensure the billing submission experience remains status quo. We will inform all practitioners, clinics and billing staff once the submission process via Accuro to the new Customer Portal is finalized. We are also working with the other billing vendors to ensure EMR submissions are similar to established process, and as simple as possible.
2. Is the support process changing? Who can I call if I encounter any issues at go-live?
When the new Claims Processing System (CPS) and Customer Portal go live, Saskatchewan Blue Cross will be providing a centralized support service all practitioner-related MSB inquiries. This will replace the various Medical Services Branch (MSB) contacts practitioners and billing clerks are currently using. All issues will be triaged, and if the issue cannot be resolved at the time of the call it will be escalated immediately to the appropriate MSB for resolution. We anticipate that this new method of handling inquiries will result in less frustration for practitioners and clinics.
3. Will we require a new hardware set-up in our offices as a result of the new Customer Portal solution and are you developing the new solution from scratch?
No, you will not have to change your hardware. As well, billing software updates are happening in preparation for the go-live date by your billing software vendor. We have been sending out communications on the new system changes for the last few months to the vendors and have been meeting with QHR Tech (Accuro) and Telus (Med Access) as well as a couple of other smaller billing vendors to answer any questions they have. We will be communicating with these on the testing process so they can begin submitting test claims to ensure that the new Customer Portal is working as it should. The new internal MSB claims processing system is based on a template from MB Health/MB Blue Cross that has been in use in MB for the past several years. It required configuration changes to "Saskatchewanize" it due to the MSB Payment Schedule differences and MSB Business Rules which are applied during the automatic adjudication of claims.
4. Assuming the new Customer Portal is web-based, will practitioners need to have a specific browser or specific operating system? Will we have to log in from a specific computer?
Our current understanding is that the Customer Portal will be compatible with all the latest browser versions i.e. Safari, Firefox, Microsoft Edge, Google Chrome. We will include this information in our letter to practitioners and clinics. The new solution is web-based, so you will not have to log in from a specific computer. As long as your account is created on the portal you should be able to log in from anywhere in Canada.
5. Security certificates are an ongoing issue within our IT operations at the clinics. Will we need to do install security certificates or adjust our settings to identify that it is safe and secure to access the Customer Portal?
The new Customer Portal does not rely on installing security certificates. The specifics of the new registration and log-in process is still in development and will be shared when available.
6. Will the new Customer Portal be integrated with the current WCB solution?
No, the new Customer Portal solution will remain a separate entity and will not be integrated with the current WCB solution.
7. Will you be able to accept batch submissions from groups?
We will continue to accept batch submissions from Groups. If your billing clerk is submitting on behalf of a number of physicians, that process will continue.
8. What file types will be acceptable to upload into the new Customer Portal?
We have not changed the file types required for claims submission. It will continue to be the .txt file type.
9. If you're not able to submit and you have to have a backup designated, how will this be accomplished in the portal to ensure that designate has the right access?
In principle, we would ask that practitioners anticipate who those submitters would be in advance so that there are no situations where you can't submit as needed. However, we realize that due to staff turnover, vacation, or illness that backups are necessary. We are currently working through this scenario and will communicate on this process in the coming months.
10. Does the project scope include the updating of ICD-9 Codes to ICD-11?
The updating of ICD-9 Codes for the claims submission process is not in the scope of this project. This is a large scale change that will involve a separate project. We do not have an ETA on this project at this time.
11. Will you be testing the Customer Portal solution prior to go-live to ensure there are no issues?
We do have a testing phase, planned for late November or December. We are currently waiting for our pre-production environment, which will be used for testing. We'll be accepting files from the vendors and they will be required to go through the testing process. Vendors will be asked to submit their test files to show that they completed the work involving the requested changes to ensure they can successfully submit to the new Customer Portal.
12. What is the cutover/transition plan for practitioners?
Practitioners and billing staff will begin utilizing the new Customer Portal either by logging into it directly on day one of go-live or via the Accuro software or your service bureau. The ICS system will most likely be inaccessible upon go-live. We are working through what the process will be to request validation reports that were produced by ICS prior to the go-live date.
13. What kind of training will be provided for my clinic staff?
Training will come in the form of webinars, job aids, and videos. As a guiding principle, webinars will be offered at different times to accommodate varying schedules and training materials will be accessible for staff to access when it is most convenient for them.
14. How will physicians provide feedback on the new submission process after go-live?
Contract information will be clearly provided to ensure there are adequate channels for practitioners to provide feedback on their user experience at and post go-live. All feedback will be considered thoughtfully before introducing any changes. We anticipate catching most CPS and Customer Portal issues prior to going live through rigorous testing.
15. What processes will be put in place to improve the quality of the Saskatchewan Blue Cross Practitioner Inquiry framework after go-live?
Ongoing status checkpoints will be scheduled during the implementation phase with Saskatchewan Blue Cross and MSB to discuss quality improvements related to service targets, knowledge materials and process workflows.
16. How can you ensure that the training for the Customer Portal will not result in disruptions to daily clinic operations and resourcing?
Our training approach will be flexible and accessible for practitioners and billing staff and will take into consideration fluctuating schedules and clinic demands. Training will be offered at different times to accommodate varying availability and training materials such as videos, user guides, and frequently asked questions will be accessible for staff to review when it works best for them. We do not anticipate the training to be overly time-consuming and at most would take an hour to complete.
We wish to thank the SMA Customer Portal User Experience group for the helpful feedback. MSB is still in the process of finalizing the Customer Portal and processes, your comments and questions will continue to assist us in ensuring the submission process will remain as seamless as possible.