Ontario WSIB

Created by Lauren I., Modified on Wed, 5 Apr, 2023 at 1:16 PM by Jessica C.

Billing WSIB electronically (Canada only)

Canadian clients can optionally bill WSIB electronically, through Telus, directly in Blueprint OMS. Please contact Blueprint Solutions for additional information on setting up electronic claim submission.

Claims are submitted nightly. Updated claim status and EFT payments are received from WSIB every Monday and Thursday morning.

Note: Telus requires periodic password updates. Be sure to forward updated passwords to the Blueprint Solutions technical team to ensure that electronic billing continues to function properly.

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

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.

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)

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.

Correct the information and re-submit the claim by right-clicking on the rejected claim from the Submitted Claims menu:

Once re-submitted, the claim will appear at the bottom of the submitted claims list, with a new submitted date of the current date. It will appear with the symbol, to indicate it is queued for transmission:

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

If the wrong patient was billed

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