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Sending Teleplan Claims

So you’ve added your Teleplan Data Center to Jane and have just had your first MSP eligible client in for a treatment, or maybe it was a WSBC claim. You’ve added the policy and billing code to the booking, now what? How do you actually get that claim to Teleplan? And what if you made an error? When will you know if the claim has been approved, or if it’s been rejected?

Let’s start in the Billing tab.

In the Claim Submissions area is where you will find a list of folders organizing all of the claims from Unsubmitted to Rejected. This is where you can go to check on the state of claims as well as make batch changes to claims such as moving them from Unsubmitted to Submitted.

This is also where you go to Submit claims to Teleplan.

The first step is to click into Unsubmitted (Teleplan), Validate the claims and then they will move into Queued (Electronic), which is the final step to Submitting the claims.

Let’s go ahead and pop into the Unsubmitted (Teleplan) folder.

Unsubmitted (Electronic)

Claim Submissions have several states for you to work with.  When a Teleplan insured appointment has been marked as “Arrived”, the insurer invoice is sent to a “Holding Pen” called “Unsubmitted” (Electronic). Claims in this Unsubmitted area can be validated by pushing the “Validate” button. When selected, Jane will review the records to confirm that all the required information has been entered correctly. If any information is missing you will see an error symbol; if everything looks great, you’ll get a green check mark. 

If you do have claims with errors, just click on the View Errors button on each claim to get the details as to why Jane has flagged the submission and make the necessary changes.

If you’re missing information (like a claim number or a PHN), you can leave the claim in this Unsubmitted area until you get the details.   

You won’t be able to submit a claim with an error to Teleplan because it will be automatically rejected.  

To send your claim into the next step, select the ready-to-go invoices, either by the Select All button and then unselecting the claims with errors. Once all the selected claims are approved a Queue for Submission button will appear. Click it to send the invoices into the Queued (Electronic) folder.

Next, it’s time to move into the Queued (Electronic) folder where those claims from the Unsubmitted folder will now be, waiting for you to Submit them.

Queued (Electronic)

Invoices wait in the Queued (Electronic) folder until you are ready to send them to Teleplan.  

Even when an invoice is in this Queued area, you can always send it back to the Unsubmitted (Electronic) folder if you realize you’re not ready to submit it. (Just use the drop down menu at the end of the invoice line.)

To submit your batch of invoices, hit the Select All button and then a Submit Selected button will appear.

You can submit as often as you like and each submission will create a Teleplan Submission record. Some clinics submit in large batches, while others submit every day – it’s totally up to you.  

Teleplan Submissions

All of your batch submissions will be listed in the Teleplan Submissions area according to the date they were submitted.  At any time, you can view the details of what was submitted, including a summary by practitioner and a detailed breakdown of the invoices submitted. 

That’s it! Once you’ve gone through the process above and submitted the claims to Teleplan they are in Teleplans hands. Claims should be submitted by close-off dates in order to be processed on the next remittance statement, which is generally every two weeks unless there is an MSP-designated holiday.

Click below to see Teleplans Close-Off and Remittance Schedule:

https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/msp/claim-submission-payment/designated-holidays-and-close-off-date

Wait, I just realized I made a mistake with the claim!

We’re human, we make mistakes and that’s okay! What your options are will depend on what state the claim is in when you realized something needs to be changed.

If the claim has NOT been submitted, simply edit the claim from the schedule or from the client’s profile and that particular purchase/invoice.

If the claim is in the Queued folder you can always send it back to the Unsubmitted (Electronic) folder. (Just use the drop-down menu at the end of the invoice line.)

If the claim has been submitted you can call Teleplan and ask them to “Zap” the claim.

If Teleplan is able to do this for you, it will be “zapped” and returned as a rejection with the explanatory code FC.

Most times, if you call Teleplan the same day the submission was made, the rejection will come back the next day. If you call the next day or later, usually, you will only see the rejection come back with the next scheduled remittance.

Once the claim appears in the Rejected folder, you will be able to correct what you need to, however, you won’t be able to make the necessary changes until that happens.

When you call Teleplan you will be asked to identify the specific claims by Data Centre, Payee Number and Sequence Number.

Data Centre and Payee Number can be found under Settings > Teleplan Info and the sequence number can be found by viewing the Teleplan Submission report for the date the claim was submitted. This is found under Billing > Claim Submissions > Teleplan Submissions.

Teleplan can be reached by calling:

604-456-6950 in Vancouver

1-866-456-6950 for all other regions of British Columbia.

The last option is called a Debit Request, which we have a dedicated guide for here: https://jane.app/guide/teleplan/debit-request-return-payment-to-teleplan

My claims are showing as Paid, what does that mean?

It means Teleplan has approved and paid for that claim and your work with that claim is done 🥳

It says Rejected? Why was my claim Rejected?

Teleplan is pretty good with providing a reason for why a particular claim has been rejected and you can look to view the rejection code and reason directly within the Rejected folder.

Once you’ve correct the errors that Teleplan has listed you can re-submit the claim. We have a guide that goes over working with those invoices in detail here: https://jane.app/guide/insured-visits/rejections

What if the claim is On Hold? Can I re-submit it to Teleplan?

With “On Hold” Teleplan Submissions, you’re not able to resubmit or change the claims until you receive a response from Teleplan (ie. Paid or Rejected).

When any Teleplan claim ends up in the “On Hold” folder, this is usually because something further is required from the Insurer (MSP, WSBC) prior to Teleplan posting payment to that claim. Sometimes the adjuster responsible for the claim might need to review the submissions before approving payment, therefore Teleplan places them on hold until they receive the “all clear” from WSBC or MSP.

If you notice that there are claims in the ‘on hold’ folder it’s important that you leave them there as they should eventually be paid or in some cases rejected. If claims remain on hold for long periods of time (i.e. longer than 6 weeks), you may find it helpful to re-connect with the Adjuster responsible for the claim, or Teleplan to inquire about the status of those claims.

If you’ve gone through all of these questions and still have questions about a particular claim, we’d be happy to take a look and point you in the right direction - feel free to send us an email at support@janeapp.com or give us a call!