TELUS eClaims · Billing integration
Direct-bill private insurers and know the answer before the patient leaves.
TELUS Health eClaims is the network Canadian clinics use to bill extended-health insurers electronically. Clinicmaster submits the claim in real time from the patient’s record, gets the adjudication back in the same exchange, and creates the invoice and insurer payment from that response — so the patient pays only their portion at the desk.
The TELUS eClaims integration
TELUS Health eClaims is a Canada-wide service that lets clinics submit claims electronically to participating extended-health and group-benefit insurers and receive an adjudication response immediately. Clinicmaster integrates over the HL7 v3 SOAP standard through a TELUS-supplied SDK: the claim goes out from the billable items on the patient’s record, and the response drives what gets invoiced to the insurer and what remains the patient’s responsibility.
What the TELUS eClaims integration does.
The value of real-time adjudication is only realised if the answer lands on the ledger. This does both in one exchange.
Real-time claim submission
The claim is built from the billable items on the visit and submitted synchronously over the eClaims network — not queued for an overnight batch.
Adjudication in the same exchange
The response distinguishes claims adjudicated as submitted, adjudicated with adjustments, and refused, so staff know immediately what the insurer accepted.
Invoice and payment created together
On a paid adjudication Clinicmaster raises the funder invoice and posts the insurer payment in one operation, so the account is settled without re-keying the response.
The patient pays only their portion
Because the insurer’s share is known before the patient leaves, the front desk collects the remainder rather than billing the whole amount and reconciling later.
Same-day nullification
A claim submitted in error can be nullified on the day it was sent, which reverses the invoice and the payment together instead of leaving an orphaned credit.
Configured to your disciplines
Submission runs under the conformance profile for your practice type, with per-clinic credentials and provider mappings configured server-side.
From treatment to settled account.
The visit produces billable items.
Charting and coding the visit creates the billable items. No separate claim form gets typed — the claim is assembled from what is already on the record.
The claim goes to the insurer in real time.
Clinicmaster sends the claim over the eClaims network under your clinic’s credentials and waits for the adjudication rather than queuing it.
The response posts to the account.
The insurer’s portion becomes a funder invoice and payment; the balance stays with the patient to collect at the desk.
What this integration does not do
Which insurers participate, what each plan covers and how a claim is adjudicated are governed by TELUS Health and the insurer — Clinicmaster submits and records, it does not decide coverage. Nullification is only available on the submission day; after that a correction is an accounting adjustment. Predetermination variants exist in the protocol but the active profiles are the chiro/physio and vision-care paths. Enrolment with TELUS Health is arranged separately.
What Clinicmaster records for every eClaim.
Real-time claiming creates an audit question — what exactly did the insurer say, and when. Each submission and its response are retained in full against the invoice.
Back to regional billing- Claim submitted and its lines
- Adjudication result type
- Amount paid by the insurer
- Patient responsibility
- Funder invoice created
- Insurer payment posted
- Adjudicated invoice status
- Nullification requests
- Response print-out for the patient
TELUS eClaims questions.
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