ResolvMD: Managing Billing Refusals

For Alberta physicians using the ResolvMD billing integration, ResolvMD will reach out with any refused billings to request clarifications.  This is usually done within 1-2 weeks via the secure messaging system within the ResolvMD platform.  If physicians choose to wait until they receive this communication, they can relay back the appropriate information via the messaging system and ResolvMD will resubmit the billings upon receiving that information.  

If the physician would like to expedite the process to be reimbursed for rejected claims quicker, we have included the steps below.

Steps to manage billing refusals on ResolvMD:

1. Sign into ResolvMD Physician Portal.  
2. Click on "Resolution Centre" on the left hand side of the page.
3. Click on ResolvMD Investigating and/or Refused on the bottom right hand side of the page.
4. Each claim that has refused, paid lower than we anticipated, or been reversed by AB Health will be listed in this section.  If you click on the claim line, a drawer will pop open on the right hand side with claim details and the explanatory code explaining the refusal.  
5. If you are able to obtain information required to resubmit the claim, using the secure messenger, please message Kara the claim number with the information you'd like to change, and she will resubmit it.  This could be anything from referral doctor, alternative coverage, a different diagnostic code, or even a different HSC.