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Claims Adjustment - Group Billing - Code I2

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How to reconcile an alternative funding plan (AFP/APP) payment

Question:

I recently joined an alternate funding plan and started shadow billing for all oncology services under Group AA5F and billing fee for service for all out-of-scope services under Group XXXX. I faxed the forms authorizing Group payment to MOH and their receipt was confirmed.

Since this happened, I have had most of my claims adjusted with the error code "I2 - service is globally funded". Is this something that I should discuss with the MOHLTC? If so, could you please tell me who is the claim administrator who I should contact?

Answer: 

I2 means the claim was successfully processed for the APP. It shows $0.00, as the specific amount deposited or funding is dependent on your APP (ie/ you are no longer fee-for-service). If the claim is rejected, you would see it our system, and you can resubmit it accordingly.

If the service code was not processed (ex/ 35 - already billed) you will see that in the report. For invoicing, our system calculates the submitted amount for all services with 'I2', and charge you accordingly.

In conclusion, 'I2' is the equivalent of a fully processed claim when billing under the APP.

 

Please see more information to our doctor billing guide here: New-doctor-billing-guide

 

 

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