Member Menu

Good faith claims

February 21, 2024

On February 6, 2024, Alberta Health announced that the claims submission process for Good Faith claims was live and available to accept Good Faith claims. Claims for dates of service between April 1, 2022 and February 6, 2024, may be submitted for payment under the Good Faith process until July 1, 2024. This will allow physicians time to submit or resubmit all backdated and stale-dated claims for payment. Good Faith claims with dates of service February 7, 2024, and onward will be subject to the 90-day submission timeframe.

Physician responsibilities


Prior to submitting a Good Faith claim, physicians or their staff should exhaust all resources to ensure that the patient is eligible for health care coverage.

Steps include:

  • Attempt to find a valid PHN for a patient by accessing:
    • Alberta Health’s IVR system (1-888-422-6257)
    • NetCare, Admission, Discharge, Transfer (ADT)/Clinical Information System (CIS) (ConnectCare, Meditech, etc.)
    • Facilities registration or health records department
  • Ensure the patient is legally entitled to be in Canada and identify their home province or territory. See below to determine eligibility.
  • Try to have the patient registered either by:
    • Recommending the patient contact AHCIP General Inquiries Line 780-427-1432 in Edmonton or 310-0000 for the rest of the province.
    • Contacting the onsite social worker to assist with AHCIP registration.

Also, please be aware that many patients are ineligible for this policy, as other arrangements/steps apply to obtain payment for medical services:

  • Federal penitentiary inmates - Contact the penitentiary for claims submission info.
  • Members of the Canadian Armed Forces – Bill Medavie Blue Cross directly.
  • Patients from Quebec – bill the patient directly at AB rates and provide a receipt OR complete this form to be paid at the QB rates.
  • Opted out patients - bill the patient directly.
  • Ukrainian Nationals who are NOT registered with the UETHBP – bill the patient directly.
  • Persons covered under the Interim Federal Health Program (IFHP) – bill IFHP.
  • WCB patients – bill WCB.
  • Temporary residents, foreign workers, students and their dependents who do not have an active visa or an expired Alberta Health Care Card – bill the patient directly.
  • Out-of-country patients – bill third-party insurance or patients directly.
  • Any patient who would not otherwise be eligible for AHCIP coverage – bill the patient directly.

With regard to out-of-province Canadian patients where a reciprocal billing arrangement exists with Alberta (i.e., all other provinces, except Quebec), the physician/clinic is advised to do the following:

  • Submit a reciprocal billing claim, if possible.
    • Patient has presented a health insurance card: submit a reciprocal claim to AH, quoting the home province health insurance number/registration number and patient’s address in their home province.
    • Patient has not presented a health insurance card: Complete the Out-Of-Province Physician or Practitioner Services form (Out-of-Province Claim Physician or Practitioner Services (gov.ab.ca) and submit by email to Health.HCIPAOOPOOC@gov.ab.ca, or fax to 780-422-4958.
  • If it’s not possible to submit a reciprocal claim, attempt to seek payment directly from the patient for services. Services should be billed at AHCIP rates.
  • If it’s not possible to submit a reciprocal claim nor bill the patient, the physician may submit a good faith claim for service.

Previously submitted claims

If you have submitted claims and received an 05A rejection or submitted claims through the email process outlined in the October 5, 2022, commitment letter, you must resubmit the claims as brand-new claims under this new process. Claims that are in the email queue will not be processed.

Submission process for Good Faith claims

  1. Be sure your software vendor has updated your system to accommodate Good Faith claims.
  2. Complete the steps listed above to try and obtain a valid PHN for the patient. 
  3. Complete the claims data information as you usually would. This includes the HSC, referring PRACID if applicable, diagnostic code, etc.
  4. Leave the recipient ULI blank and the service recipient registration number blank.
  5. Check the Good Faith Indicator Field is set to “Y”. 
  6. Complete the patient data segment; this includes first and last name and date of birth. Gender, complete address including postal code. TIP: do not use dashes, abbreviations, or punctuation in the address field. This will result in the claim being refused. You must complete all personal data fields to submit the claim.
    • Homeless patients - the address of the nearest homeless shelter to the hospital may be used as the patient's address.
  7. Do not add text to the claim. This will result in delayed payments.

Awaiting information from Alberta Health: Circumstances where the patient obtained AHCIP coverage between the date of care and the date the good faith claim is submitted.  We understand Alberta Health has rejected these claims as they appear ineligible for good faith and exceed the 90 day rule.  An update will be provided when further information is received.

Information session

A member information session was held on February 16. Information was provided about the good faith claims process, including patient eligibility, how to submit new claims, how to submit for past claims that were rejected because of patient ineligibility and what steps physicians and their teams will need to take before submitting.