Clincial ARP Service Codes

Clinical ARP Service Codes

Are the time modifiers changing with these new ARP service codes for our sessional program?

No, the billing process using the TM modifiers is unchanged.

Can I continue to use the APL codes after the new ARP Service codes are implemented?

The new ARP Service Codes will be implemented on January 1, 2020, but there will be a grace period for using the APL codes until January 31st for cARP services provided during that month. Any claims submitted for services provided after January 31st using the APL codes will be rejected. It is important to submit claims for all services provided prior to January 31st.

Do I continue to use the SOMB for my shadow billing?

Yes, all cARP participating physicians must continue to use the SOMB Health Service Codes to submit their Service Event Reporting to the Ministry, whenever applicable. A complete listing of SOMB HSCs is available on the Alberta Health website at: www.health.alberta.ca/professionals/SOMB.html. The AMA’s Fee Navigator is also a convenient reference: https://www.albertadoctors.org/fee-navigator .

How long does documentation have to be kept?

All documentation related to the operation and management of the ARP, in addition to information supporting claims for benefits and financial records, must be kept for 10 years as outlined in the Ministerial Order Program Parameters.

I also work in an AMHSP, do I also use the ARP Service Codes for my shadow billing for that program?

No, at this time, the ARP Service Codes will only used by the cARP programs. The AMHSPs will continue to use the APL codes until further notice from Alberta Health.

I cannot find a code that meets our cARPs needs for reporting service activity. What should I do?

Please contact your ARP PSS Consultant to discuss your needs. Your consultant will help you address any urgent needs. All requests for new codes will be tracked, reviewed and addressed collaboratively by Alberta Health, the AMA and ARP PSS on a regular basis.

I do not see these ARP Service Codes in Connect Care, whom do I contact?

Your AHS contact for Connect Care should be able to assist you.

I noticed that some of the ARP Service Codes are restricted. How do we get permission to use those codes for my cARP?

Please contact your ARP PSS consultant if you require permission to use a restricted code. Requests for permissions to use restricted codes will be tracked, reviewed and addressed collaboratively by Alberta Health, the AMA and ARP PSS on a regular basis.

Physicians have 180 days to submit their billings. Do I use the old APL (non-SOMB) codes for services provided up until December 31, 2019, or do I use the new ARP Service Codes for services provided prior to December 31, 2019 when submitting my final billings in 2020?

The change is based on service date not claim submission date, so claims for any services provided prior to January 1st would use the APL (non-SOMB) codes. Claims for services provided during January could use both. Claims for services provided after January 31st must use the new ARP Codes. The submission date does not matter.

What do I do if I have an issue with a code?

Please contact your ARP PSS Consultant if you have an issue. Your consultant will help you address any urgent concerns and all issues, which will be tracked, reviewed and addressed collaboratively by Alberta Health, the AMA and ARP PSS on a regular basis.

Why were the new ARP service codes created?

A review and analysis of the 253 Allied Provider List (APL) (non-SOMB) codes identified issues including duplication, unclear definitions, absent time modifiers for some of the codes and limited usefulness for providing program accountability to the Ministry. In addition, some of these codes were no longer needed, as they had been incorporated into the SOMB Health Service Codes.

Will my billing submitter know about the new ARP Service Codes and where can they go for more information?

Yes, the billing submitter downloads have been posted on H-Link. They should look for a file named ARP Schedule of Service Activity – January 1, 2020.zip. As usual, submitters can contact H-Link by phone or email with any questions.

Will these new ARP service codes affect the system assessed value for our cARP when our program’s data is reviewed?

As the program is transferring codes, the time for the service activity should remain the same, and therefore, not impact the assessed system value, providing that the reporting is accurate.