Medical Billing Day Sheets Templates
Hospital Day Sheet - Created by Dr Hani Redwan
If you have a day sheet template that you would like us to post online, please send it to us.
WCB- Form for First Report and Progress Report
Click here to download a WCB Physician's First Report
Click here to download a WCB Physician’s Progress Report
Business Arrangement (BA) Request
How to Begin:
To start submitting to AHW on your behalf we need a BA number. You can hold multiple BA numbers so do not be concerned that you have one with another submitter.
Click here to download BA Request
For either an individual physician or for a clinic to request a new BA
Click here to Download a request to add a physician to an existing BA
For clinics to add new physicians to their BA
Completing the BA request:
1. Fill in your Practitioner ID.
2. Make the "Effective Date" before the date of your first unclaimed day sheet so that we can submit your past claims as well as future ones.
3. Check if you want your money deposited in your personal bank account or in your PC bank account.
4. Fill in your the Skill Code. Eg: GP, INMD, OBGY, etc.
5. Attach a voided cheque.
6. Sign both lines of Section C and date. Fax the BA request and your voided cheque to us toll free at 1 (888) 455-2683.
We can fill out the rest for you and submit it on your behalf.
Your money goes directly into your bank account and we invoice you for our billing fees. AHW will send you your BA number in approximately 10 days.
Assign us as the submitter on an unattached Business Arrangement Number
If you have been issued a BA number already:
Click here to download a AHCIP-form-AHC2096.pdf form
1. Download AHC2096
2. Complete the sections for the“Contract Holder.” Leave the “Submitter” sections blank.
3. Sign and return this form to us via fax at 1 (888) 455-2683 or email it to submissions@albertabilling.com.
4. We will forward the request to Practitioners Registries on your behalf.
We can begin submitting your claims to AHW within a couple of days. Your money goes directly into your bank account and we invoice you for our billing fees.
Alberta Medical Billing Client Agreement
We require a signed copy of this Client Agreement prior to submitting any of your claims.
Click here to download a Alberta Billing Client Agreement