Ontario WSIB

Billing WSIB electronically (Canada only)

1. After allocating a sale to WSIB, click the Tools drop-down menu, and select Electronic billing. 

2. On the Unbilled invoices tab, click on the desired invoice, and click SUBMIT CLAIMS.

   To submit multiple claims, press and hold the Control key (Ctrl) on the keyboard while clicking the desired invoices.
   Claims on the Unbilled invoices tab with a triangle alert symbol contain one or more items that do not have correct WSIB coverage, or the insurance-covered price in the Setup menu does not match the price on the invoice. Click on the submitted claim and click TRANSACTION DETAILS, or double-click the claim, to review the details. In the Review order screen, items without coverage are denoted with a triangle alert symbol. Edit the invoice, optionally adding coverage to the item(s), and then submit the claim.

   
   

   1. Click the Submitted claims tab to view submissions. The icon next to each claim indicated the claim status.

      Status icon	Claim status
      	Rejected (see Rejected claims below)
      	Queued for transmission to Telus
      	Received and acknowledged by Telus
      	Adjudicated and approved in full
      	Adjudicated and approved with adjustment(s)
      	Paid in full
      	Paid with adjustment(s)

      
      

      
      

3. On the Submitted claims tab, optionally do any of the following:

   • Use the location drop-down menu to view one, or <All>, location(s).

   • Optionally, click on a submitted claim and click CLAIM DETAILS to view claim items.

   • Optionally, click on a submitted claim and click CLEAR CLAIMS to remove it from the screen.

     Ensure WSIB payments have been entered, prior to clearing the claim. Clearing a claim will remove the invoice from the Enter 3rd party payment screen.
     To clear multiple claims, press and hold the Control key (Ctrl) on the keyboard while clicking the desired invoices.

Rejected claims

No Insurer Claim # present

Claims on the Submitted claims tab with a triangle alert symbol (and no Insurer Claim # present) have been rejected immediately, without adjudication by WSIB. Claims are rejected without adjudication if one of the following items in Blueprint does not match what WSIB has on file:

• Patient's birthdate
• Patient's WSIB ID number. Ensure the WSIB ID number has been entered without a "-0" at the end. It should be entered as 8 digits only.

Insurer Claim # present

Claims on the Submitted claims tab with a triangle alert symbol and an Insurer Claim # present, have been adjudicated by WSIB. To see why a claim was denied, double-click on the claim to open the details, or click on the claim and click the CLAIM DETAILS button. Then, hover the mouse over the exclamation mark on each line item in the Claim details screen. The WSIB explanation code(s) and message will appear.

Correcting errors after a claim has been submitted

Once a claim has been submitted electronically, editing the original invoice in Blueprint will not change the information which has been submitted to WSIB. In addition, it's not possible to delete an invoice in Blueprint if an electronic claim has been submitted for the invoice.

The recommended process for handling incorrect claims is as follows:

If items are missing from the original invoice

• Create a new invoice for the missing items, and then submit a claim for the new invoice electronically

If the wrong items were billed, or the items had incorrect WSIB codes or prices

• Make any required corrections in the Blueprint Setup, then create a new invoice and submit a claim for it electronically
• Process a return for the original invoice
• On the Telus portal, cancel the incorrect claim so that it does not interfere with the processing of the corrected one

1. Return the original invoice(s) in Blueprint OMS which had their payment taken back on the new WSIB remittance.
2. Enter the new WSIB remittance in Blueprint, with the total Amount Allowed as the payment amount.
3. Click the Use credits button within the third-party ledger and select all return credits from step 1 above. These should equal the total Amount adjusted on the new remittance.
4. Ensure that the payment is applied to all the invoices specified on the new remittance and save the payment.

1. Unapply the payment received previously for the invoices which had their payment taken back on the new WSIB remittance.
2. Enter the new WSIB remittance in Blueprint, with the total Amount Allowed as the payment amount.
3. Click the Use credits button and select all the unused amounts from the previous payments from step 1 above, which should equal the total Amount adjusted on the new remittance.
4. Ensure the payment is applied to all the invoices specified on the new remittance and save the payment.
5. Write off the invoices which had their payment taken back on the new WSIB remittance (i.e. invoices in step 1 above).

If the wrong patient was billed

• Process a return for the original invoice
• On the Telus portal, cancel the incorrect claim