How the review works
Software reads your notes and checks them against the Manitoba fee schedule. We prepare the claims. You confirm each one before anything is submitted.
The review, step by step
We read your notes
Notes are de-identified before analysis. Your clinic removes names and health numbers on its own system, with our help. Free text can still hold details that point to a patient, so software checks each note again and holds back any note that fails.
Software then reads each visit note. It lists the facts that matter for billing when the note states them. These include what you did and the issues you addressed. They also include when the visit started and how long it took. A detail the note does not state is marked as missing, not guessed.
Each fact must be quoted word for word from your note. Our code checks every quote. A fact whose quote is not in the note is dropped.
Software: reads the note and quotes the facts.
You: an export of your visit notes and your billing for the same agreed period. You keep writing notes the way you do now.
We check them against the Manitoba fee schedule
Rules we wrote from the Manitoba Physician's Manual turn those facts into claims. The rules run in ordinary code. The tariff code and the fee come from the fee schedule in that code, not from the language model.
Some fee schedule conditions are often not written in a note. Visit length is one. When the review has to assume one, we say so and mark the item for you to check.
Software: applies the fee schedule rules to the quoted facts.
You: nothing yet.
We prepare the claims
Each claim lists the tariff code and the fee. It also shows the visit date and the words in your note that support it. Some items need a detail the note does not state, such as the time a visit started. We turn most of these into a question for you, not a claim.
A second software check tests each possible missed item against the text of the manual. Items that fail it are not shown to you.
Software: drafts the claims and the questions.
We: review the items the software flags as unclear.
You confirm
You see each claim beside your note, with the supporting words highlighted. You confirm it or decline it.
Some items need a detail the note did not state. Confirm one only if you did it and remember it, or a record such as your appointment schedule shows it. We draft a short addendum with only that detail. You save it in your chart, dated the day you write it and marked as an addendum. Your original note is not changed. The item can be billed only after you confirm it and the addendum is saved.
You: one sitting to go through the report, and confirm or decline each item.
You or your biller submit
We do not submit claims and we do not connect to your EMR. You or your biller submit the confirmed claims to Manitoba Health, the way you do now. Check each claim the way you would check your own before you submit it.
You or your biller: submit the claims you confirmed.
Who does what
| Task | Done by |
|---|---|
| Read each note and quote the facts | Language model |
| Check every quote against the note | Fixed rules in our code |
| Pick the tariff code and fee | Fixed rules from the fee schedule, in our code |
| Review items flagged as unclear | Us |
| Confirm or decline each claim | You |
| Submit claims | You or your biller |
What the audit report shows
The report gives three figures and a list of what could not be assessed. We show the figures separately and never add them together, because they are different kinds of numbers.
Billable now
Services your notes already support that were not billed. Each one is listed with its visit date, tariff code and fee. Manitoba Health pays a claim only if it is submitted within its time limit. Older items are shown separately, as past the submission time limit, and are not counted as billable.
Billable once you confirm a detail
Services that need one detail from you before they can be claimed, such as the time a visit started. Each needs an addendum in your chart before it is billed.
Documentation habits
Details your notes often leave out that the fee schedule asks for, such as the time a visit started. This figure is shown separately and never added to the others. It is not payment for past care.
Not assessable
Many EMR exports leave out visit start time, patient age or enrolment. Where a claim depends on one of these, we list it as not assessable rather than guess.
What we need from you
For the audit we need two things for the same period. The first is a de-identified export of your visit notes. The second is your claims or remittance report from Manitoba Health, so we can see what was billed.
We agree the period and the export method on a short call before anything is exported. Only the de-identified note text leaves your clinic, and only to be read by the language model. After that, your time is one sitting to go through the report.
The first audit is free. It covers three months of notes for one doctor.
Book an audit
The first audit is free. It covers three months of notes for one doctor. Tell us how to reach you and we will reply within one business day.