Community Care Access Centre (CCAC)
Billing Reconciliation Report Format Specification
Date: October 23, 2009
Organization:
Ontario Association of Community
Care Access Centres (OACCAC)
Division:
Business Solutions
Version:
2.10
Version Date:
October 23, 2009
Prepared By:
Ion Moraru
Updated By:
Ellen Hsu
1
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Revision Log
Version
No.
Version Date
Summary of Change
Changed
by/Input from
1.0
October 19, 2007
First draft
Guy Fortin
1.1
October 22, 2007
Updated valid value list in ServiceType description
Guy Fortin
Changed size of ClientReferralCode from 2 to 12 (typo
1.2
November 13, 2007
Change VendorCost $$ attributes mandatory
Guy Fortin
Add attribute LineItemStatusReasonCode to
BillingLineItem and Appendix A to list valid codes
1.3
December 4, 2007
Change VendorContractCode and ProviderContractCode
to ContractCode
Guy Fortin
Add VendorSuppliedLineItemNumber to BillingLineItem
Remove inappropriate values from LineItemStatus
Change from multiple Reason Codes (one per Item type)
to a single Reason Code for all types in Appendix A
Add a Date and Time Description in chapter 2
2.0
January 25, 2008
Renamed BillingRAReport element to
BillingReconciliationReport
Added ReconciliationId to BillingReconciliationReport
Changed VendorInvoiceDate from Optional to Mandatory
Added GeographicalArea to BillingLineItem element
Added ClientFirstName to Client element
Moved VendorCost element from BillingLineItem element
to EquipmentAndSupplyItem element
Moved ContractCode from EquipmentAndSupplyItem and
PurchasedServiceItem element to BillingLineItem
element
Change DeliveryDate and StartDate from Optional to
Mandatory in EquipmentAndSupplyItem element
Added ServiceOrderId to PurchasedServiceItem element
Moved QuantityBilled from PurchasedServiceItem
element to BillingLineItem element
Date: October 23, 2009
2
Guy Fortin
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Version
No.
Version Date
Summary of Change
Changed
by/Input from
2.1
Feb 7, 2008
Added BillingLineItems element to
BillingReconciliationReport element
Guy Fortin
Added ContractName to BillingLineItem
Added ItemOrderType and RecordType attributes to
EquipmentAndSupplyItem element
Made VendorCost, Type, and UnitDollarRate mandatory
on E&SItem
Made ServiceOrderId mandatory on PurchasedServiceItem
Made ProviderActivityCode optional on
PurchasedServiceItem
Updated Appendix B with diagrams instead of condensed
XML
2.2
Feb 7, 2008
Added ServiceDeliveryType and LocalDistinction to
PurchasedServiceItem Service element
Added ServiceDeliveryType Appendix
2.3
Feb 19, 12008
Added ReportType and LineItemCount to
BillingReconciliationReport element
Made TotalVendorPayable element Optional
Moved all fields from the BillingLineItem element to the
EquipmentAndSupplyItem and PurchasedServiceItem
elements
Removed UnitDollarRate from EquipmentAndSupplyItem
Moved GeographicArea from PurchasedServiceItem to
Service element
2.4
Feb 19, 2008
Date: October 23, 2009
Added Type attribute to PurchasedServiceItem
3
Guy Fortin
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Version
No.
Version Date
Summary of Change
2.5
March 3, 2008
Reflect Feedback from CHRIS Team review
-
-
2.10
Changed
by/Input from
Make TotalVendorPayable mandatory
Change PayableAmountWithTax to
PayableAmountWithoutTax
Deleted RecordType, and ItemOrderType attributes
and GeograpicArea from EquipmentAndSupplyItem
element
Made OriginalItemDescription, DeliveryDate,
StartDate optional in EquipementAndSupplyItem
Change BillingAmountWithTax to
BillingAmountWithoutTax in
EquipementAndSupplyItem
2.6
March 7, 2008
Renamed ClientReferralCode to BillingReferenceNumber
and moved it from Client sub-element to
PurchasedServiceItem and EquipmentAndSupplyItem
element
2.7
May 27, 2008
Renamed ServiceOrderID to ProviderAssignmentId in the
PurchaseServiceItem element.
Added RecordType attribute to the
EquipmentAndSuppliesItem element.
Date: October 23, 2009
4
Ion Moraru
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Version
No.
Version Date
Summary of Change
Changed
by/Input from
2.8
June 18, 2008
Added TransmissionDateTime to the main element
Ion Moraru
Added SpecialtyCode to the Service element
Removed ContractName from EquipmentSupplyLineItem
and PurchaseServiceItem element
Changed the QuantityBilled’s type to decimal
Renamed to DeliveryDateTime and changed the type to
datetime.
Added a new element RentalBillingPeriod and moved
Start Date and End Date under it.
Removed R-2 reason code for Debit/Credit edit check.
2.9
September 15,
2009
Turned TotalVendorPayable into a simple (decimal) type
instead of an complex type.
Ion Moraru
2.10
Oct 21, 2009
Change Mandatory fields to Optional:
ClientIdentifier, VendorInvoiceDate
Ellen Hsu
DeliveryDateTime changed to DeliveryDate
Change DateTime to Date:
VendorInvoiceDate, LastProcessedDate, DeliveryDate,
LastProcessedDate, RentalBillingStartDate,
RentalBillingEndDate, VisitDate
BillingAmountWithoutTax changed to AmountBilled
Change Line Item Status Reason Code
Change Description in LineItemType and AmountBilled
OrganizationCode changed to OrganizationName
Date: October 23, 2009
5
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Table of Contents
1.
Billing Reconciliation Report ..................................................................................... 7
1.1
1.2
2.
Brief Description
High Level Structure
7
7
Billing Reconciliation Report Elements ..................................................................... 8
2.1
2.2
2.3
2.4
BillingReconciliationReport element detail
BillingLineItem element detail
EquipmentAndSupplyItem element detail
PurchasedServiceItem element detail
8
10
10
14
3.
Appendix A - Line Item Status Reason Code ......................................................... 20
4.
Appendix B - Service Delivery Type ....................................................................... 24
Date: October 23, 2009
6
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
1. Billing Reconciliation Report
1.1 Brief Description
When a Billing Invoice is processed by a CCAC, a Billing Reconciliation Report is sent back to
the vendor or provider to communicate the status of each item billed. The Billing Invoice is
described in the CCAC Billing Invoice Format Specification document.
This document specifies the information and associated format that make up a Billing
Reconciliation Report.
1.2 High Level Structure
The Billing Reconciliation Report is an XML document with the following high level element
structure:
BillingReconciliationReport
Contains 1 to several
BillingLineItem
Contains one of
PurchasedServiceItem
EquipmentAndSupplyItem
As the diagram above depicts, a BillingReconciliationReport element may contain from one to
several BillingLineItem elements. A BillingLineItem element can then in turn contain one of
either an EquipmentAndSupplyItem or a PurchasedServiceItem element. These four elements
represent the high level structure of the Billing Reconciliation Report.
Date: October 23, 2009
7
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
2. Billing Reconciliation Report Elements
The following tables document the fields and elements that make up a Billing Reconciliation Report.
A note about Date and Time specification:
All dates and times contained in the specification adhere to the W3C Universal Time Code (UTC)
standard and are formatted as follows:

date: yyyy-mm-dd (size 10 bytes); e.g. 2007-11-21

datetime: yyyy-mm-ddThh:mm[:ssTZD]; (size 16 bytes - if omitting ss and TZD - and 25 bytes
with ss and TZD); e.g. 2007-11-21T14:56:19-05:00 (for EST timezone)

time: hh:mm[:ssTZD] (size 5 - if omitting ss and TZD - and 14 bytes with ss and TZD); e.g.
14:56:19-05:00
Where "yyyy" represents the year, "mm" the month from 01 through 12, "dd" the day of the month,
"T" separates the date from the time, "hh" the hour from 00 through 24, "mm" the minutes, "ss" the
seconds and TZD represents the timezone which reflect the times difference relative to GMT, so it
can range from +12:00 to -13:00; both "ss" and TZD are optional; TZD is not yet supported by this
specification.
2.1 BillingReconciliationReport element detail
Name
Version (Attribute of
BillingReconciliationReport
element)
Field
Length
(bytes)
Type
Mandat
ory?
Description
Flat
File
Max 10
Num
Yes
The version of the Schema
that this
BillingReconciliationReport
document adheres to. E.g.
"1.0". This is required for
the receiving vendor /
provider to correctly
interpret the information
being provided by the
CCAC
N/A
ReportType
25
Alpha
No
One of "Purchased
Service" or "Equipment and
Supplies"
N/A
InvoiceFileNumber
25
Alpha /
num
Yes
CCAC unique id for this
report
N/A (for
E&S)
Reconcili
ationID
(for PS)
Date: October 23, 2009
8
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
OrganizationName
250
Alpha
Yes
The Organization name
based on the Organization
Code assigned to Vendor
by local CCAC. Reference
may be “provider” or
“vendor” organization
CcacCode
2-4
Alpha
Yes
A unique number for the
CCAC. Valid values are:
"ESC" |"SW" | "WW" |
"HNHB" | "CW" | "MH"
|"TC" | "CENT"|
"CE"| "SE" | "CHAM"|
"NSM"| "NE" | "NW"
CCACId
Date
No
The vendor provided Date
on the Billing Invoice
N/A
Alpha
numeric
No
The
vendor
provided
Invoice Number on the
Billing Invoice
InvoiceFil
eNumber
(for E&S)
VendorInvoiceDate
VendorInvoiceNumber
10
Max 50
N/A
PS)
LineItemCount
5
Num
Yes
The number of line items
included in the report
(for
TotalLineI
temCount
(for E&S)
RecordCo
unt
(for
PS)
TotalVendorPayable
10
Num
Yes
The total amount with taxes
included
N/A (for
E&S)
TotalPaya
ble
(for
PS)
BillingLineItems (element)
TransmissionDateTime
Date: October 23, 2009
10
Element
Yes
A list of 1
BillingLineItems
DateTime
Yes
The date and time this
transmittal occurred.
9
or
more
N/A
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
2.2 BillingLineItem element detail
Field Type
Length
Name
Mandatory Description
?
(bytes)
BillingLineItems (list)
element
Yes
List of either
EquipmentAnsSupplyItem or
PurchasedServiceItem elements
2.3 EquipmentAndSupplyItem element detail
Name
Field
Length
(bytes)
Type
Mandat
ory?
LineItemType (attribute of
EquipmentAndSupplyItem)
Max 10
Alpha
Yes
Description
Flat File
Identifies this Line
Item as either a
"Rental" |
"Purchase"
LineItemType
Finance item will
be identified as
“Purchase”
Client (Element)
ClientIdentifier
-
12
-
Yes
An Element that
contains the
following client
information fields
Alpha/
No
A code that
identifies the
Client associated
with this item.
This number was
provided by the
CCAC at time of
order
Num
Date: October 23, 2009
10
N/A
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Surname
ClientLastName
50
Alpha
Yes
The last name of
the Client
associated with
this item. This
information was
provided by the
CCAC at time of
order
ClientFirstName
50
Alpha
No
The first name of
the Client
associated with
this item. This
information was
provided by the
CCAC at time of
order
12
Alpha/Nu
m
Yes
A code that
identifies the
Client Referral
associated with
this item. This
number was
provided by the
CCAC at time of
order
BillingReference#
ContractCode
Max 15
Alpha/Nu
m
Yes
Contract Number
assigned to
Vendor by the
CCAC when the
contract was
entered into
VendorContractCode
VendorSuppliedLineNumber
Max 15
Alpha /
num
No
An optional value
supplied by the
vendor in the
Invoice that is
returned back to
the vendor by the
CCAC in the
Reconciliation
Report
Vendor Reference
BillingReferenceNumber
Date: October 23, 2009
11
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
PurchaseOrderNumber
Max 15
Alpha/nu
m
Yes
The Purchase
Order number
provided by the
CCAC at time of
order
PO Number
PurchaseOrderLineNumber
Max 15
Alpha/nu
m
Yes
The code that
identifies this Line
Number to the
CCAC; provided
by the CCAC at
time of order
PO Line Item#
VendorItemCode
Max 15
Alpha/nu
m
Yes
The code that
identifies the
specific item
ordered and
delivered to the
client; Assigned
by CCAC
VendorItemCode
LineItemUnitCode
Max 10
Alpha
Yes
Code for the units
in which the item
has been
delivered (e.g.,
UNIT,EACH,
CASE, BOX, SET,
DOZ, GROSS)
ItemUnitCode
QuantityBilled
Max 8
Num
Yes
The number of
Units being billed
for by this item
(decimal 6.2).
Quantity
DeliveryDate
10
Date
No
Date Equipment
was delivered.
Mandatory for
Purchased Items.
StartDate
Element
Yes
The result of the
line item billing
reconciliation.
ReconciliationOutcome
Date: October 23, 2009
12
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
LineItemStatus
15
Alpha
Yes
2.10
The CCAC
determined status
for this line item.
Possible values
include:
ProcessingStatus
Payable
Rejected
Suspended
LineItemStatusReasonCode
LastProcessedDate
RentalBilllingPeriod
Max 15
10
Alpha
Date
element
No
Identifies the
reason for the line
item to be
Suspended or
Rejected. See
Appendix A for a
listing of valid
codes
ReasonCode
Yes
The date when
the CCAC last
Processed this
item
ProcessingDate
No
RentalBillingStartDate
Max 10
Date
Yes
The Rental start
date from the
invoice
StartDate
RentalBillingEndDate
Max 10
Date
Yes
The Rental end
date from the
invoice
EndDate
element
Yes
An Element that
contains the
following cost
information
VendorCost (element)
Date: October 23, 2009
-
13
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
Type(attribute)
6
Alpha
Yes
Attribute of the
VendorCost
Element with
value DEBIT or
CREDIT to
identify this line
time as either a
DEBIT or a
CREDIT to the
CCAC. DEBIT is
the default.
N/A
AmountBilled
8
Num
Yes
Amount being
billed for this item
AmountPayable
GST
5
Num
Yes
Amount of Goods
& Services Tax for
this item
GST
PST
5
Num
Yes
Amount of
Provincial Sales
Tax for this item
PST
2.4 PurchasedServiceItem element detail
Name
Type (attribute)
Client (Element)
Date: October 23, 2009
Field
Length
(bytes)
Type
Mandat
ory?
15
Alpha
-
-
14
Description
Flat File
No
One of "Debit" or
"Credit" (default to
“Debit”)
N/A
Yes
An Element that
contains the
following client
information fields
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
ClientIdentifier
12
Alpha/
2.10
No
A code that identifies
the Client associated
with this item. This
number was
provided by the
CCAC at time of
order
N/A
Num
ClientLastName
50
Alpha
Yes
The last name of the
Client associated
with this item. This
information was
provided by the
CCAC at time of
order
Surname
ClientFirstName
50
Alpha
No
The first name of the
Client associated
with this item. This
information was
provided by the
CCAC at time of
order
N/A
ProviderAssignmentId
25
Alpha /
num
No
The unique number
that identified this
item when it was first
ordered
N/A
BillingReferenceNumber
12
Num
Yes
A code that identifies
the Client Referral
associated with this
item. This number
was provided by the
CCAC at time of
order
BillingReferenceNum
ber
No
Contract Number
assigned to Vendor
by the CCAC when
the contract was
entered into
N/A
ContractCode
Date: October 23, 2009
Max 15
Num
15
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
VendorSuppliedLineNumber
Max 15
Alpha /
num
No
An optional value
supplied by the
vendor in the Invoice
that is returned back
to the vendor by the
CCAC in the
Reconciliation Report
N/A
QuantityBilled
Max 8
Num
Yes
The number of Units
being billed for by
this item.
Quantity
ProviderBillingCode
4
Num
Yes
A billing code
assigned to the
provider contract
which represents a
rate and a period of
time
BillingCode
Service (element)
-
element
Yes
An Element that
contains the
following three fields
to describe the
Service that is being
billed for in this item
Date: October 23, 2009
16
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
ServiceType
Date: October 23, 2009
Max 30
Alpha
Yes
17
2.10
Assigned by CCAC.
Identifies the general
service delivered to
the client; valid
values are:
AMB
Ambulance
Services - CCAC
AT
Attendant
Care - CCAC
DP
Adult Day
Program - CCAC
ENT
Enterostoma
l Therapy
ER
Children's
Enhanced Respite
Service
GER
Psychogeriat
ric Resource Coord CCAC
HOM Home
Support
(Homemaking)
LAB
Laboratory
Services - CCAC
MOW Meals on
Wheels - CCAC
NP
Nurse
Practitioner
NUR
Nursing
NUT
Nutritional
Services
ODB
Ontario Drug
Benefit
OT
Occupational
Therapy
PAS
Pastoral
Care
PHA
Pharmacy
Consultation
PHY
Physician
PM
Paramedical
Services - CCAC
PSM
Palliative
Pain & Sympton
Mgmt
PSY
Psychology
PT
Physiotherap
y
RT
Respiratory
Therapy
SH
Supportive
Housing - CCAC
ServiceCode
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
ServiceDeliveryType
UnitOfService
SpecialtyCode
2.10
Max 50
Alpha
Yes
Identifies a more
specific service
within the general
ServiceType to be
delivered to the
client; See Appendix
B for list of valid
values
N/A
Max 6
Alpha
Yes
Code assigned by
CCAC for the units in
which the service
has been delivered
(e.g., HOUR, VISIT)
ServiceUnitCode
Max 20
Alpha
No
Specialty designation
required for this
service. Please refer
to Appendix B for
Service specialties
associated with
Service Delivery
Types.
N/A
GeographicArea
250
Alpha /
num
No
CCACs can further
define contracts
specific to a
geographic area, or a
local contract
distinction.
N/A
LocalDistinction
250
No
In addition to
geographic areas,
contracts can be
further defined by
other locally defined
distinctions.
The local distinction
will be used by
CCACs who have
separate contracts
for specific client
groups, such as
Children / Adults /
ABI distinctions for
OT.
Date: October 23, 2009
Alpha /
num
18
N/A
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
ProviderActivityCodes (list)
VisitDate
Max 50
Alpha
No
A list of Activity Code
elements that
Identifies the service
provider activity with
the client.
ServiceActivities
10
Date
Yes
The date when the
service was
delivered
VisitDate
Element
Yes
The result of the line
item billing
reconciliation.
15
Alpha
Yes
The CCAC
determined status for
this line item.
Possible values
include: Payable |
Rejected |
Suspended
ProcessingStatus
Max 15
Alpha
No
Identifies the reason
for the line item to be
Suspended or
Rejected. See
Appendix A for a
listing of valid codes
ReasonCode
10
Date
Yes
The date when the
CCAC last
Processed this item
DateProcessed
ReconciliationOutcome
LineItemStatus
LineItemStatusReasonCode
LastProcessedDate
Date: October 23, 2009
2.10
19
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
3. Appendix A - Line Item Status Reason Code
The following are the valid reason codes for when a line item status has been Rejected or Suspended
Reason
Code
Description
FUTURE
Invoice Start Date is in the future.
DBTFLG
Debit/Credit Flag is not equal to 'D'
REFERR
Billing Reference Number not found in CHRIS
LINERR
Line number submitted does not exist on the Referral specified
VNDERR
Vendor code submitted does not match vendor on the order
ITMERR
Item code submitted does not match item code on the order
CANCEL
This item is cancelled
CAPPED
This item is has reached the capped amount
QTYERR
Quantity invoiced is not 1
NOAMT
Amount invoiced = 0
TOOOLD
This item has been invoiced too late
PAID
The vendor has already been paid for the billing period invoiced
STARTD
Billing period start date does not match the rental start date on the line item order
GAP
There is a gap between the billing period invoiced and the previous billing period
OVRLAP
The billing period invoiced overlaps with the previous billing period
ESTEDT
Submitted end date is after item estimated end date
ENDED
Submitted end date is after item rental end date
BILPRD
Billing Period must be between 28-31 days.
NORATE
No rate record in table for billing start date
Date: October 23, 2009
20
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Reason
Code
2.10
Description
COSERR
Invoiced cost does not match calculated cost
PSTERR
PST invoiced does not match calculated PST
GSTERR
GST invoiced does not match calculated GST
FUTURE
Invoice Visit Date is in the Future
DBTFLG
Debit/Credit Flag is not Equal to 'D'
REFERR
Billing Reference Number not found in CHRIS
SVCERR
No service exists for this referral
NOACT
Activity Code is missing
ACTERR
Activity code is invalid for service code on claim
VEDERR
Billing Code Submitted Is Not Valid For Service Authorized
NOQTY
No quantity submitted for hours
TOOOLD
Visit Date exceeds maximum billing days.
DISCHG
Visit Date greater than provider discharge date
ASGNDT
Visit Date less than provider assignment date
USEDUP
Quantity submitted exceeds units of service authorized for the date of service on the claim .
COSERR
Amount Submitted not equal to amount for billing code submitted
NORATE
No billing code rate is recorded on the system for the visit date
FUTURE
Invoice Delivery Date is in the future
DBTFLG
Debit/Credit flag is not equal to 'D'
REFERR
Billing Reference Number not found
LINERR
Line number and PO submitted does not exist on the referral specified
Date: October 23, 2009
21
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Reason
Code
2.10
Description
VNDERR
Vendor code submitted does not match vendor on the order
ITMERR
Item code submitted does not match item code on the order
CANCEL
This item is cancelled
QTYERR
Quantity invoiced is 0
NOAMT
Amount invoiced = 0
TOOOLD
This item has been invoiced too late
USEDUP
Quantity submitted exceeds the Available Quantity
NORATE
No rate record in table for delivery date
COSERR
Invoiced cost does not match calculated cost
PSTERR
PST invoiced does not match calculated PST
GSTERR
GST invoiced does not match calculated GST
ENDDT
Visit Date greater than provider end date
SAFERR
SAF Reference is not found in CHRIS
DUPBRN
Billing Reference Number has resolved to more than one referral
INVBC
Invalid Billing Code. The visit date and billing code do not correlate to a clients authorized service.
BILLCD
Billing Code on submitted line item does not match to any contract for the provider
BLLPRV
Billing Code on submitted line item does not exist for the provider.
PROCTC
Visit Date on submitted line item does not exist within the date range of the provider contract.
BCCTC
Visit Date on submitted line item does not exist within the date range of the billing code.
DUPBRN
Billing Reference Number has resolved to more than one referral
DUPLN
PO, VCC or VIC is duplicated for the BRN submitted in CHRIS.
Date: October 23, 2009
22
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Reason
Code
2.10
Description
DUPBRN
Billing Reference Number has resolved to more than one referral
DUPLN
PO, VCC or VIC is duplicated for the BRN submitted in CHRIS.
SDTERR
Billing Code is invalid for the Service Delivery Type authorized for the specified client.
ORGERR
The organization code associated with the line item does not match the organization code on the billing file.
TAXON
Add tax to line item.
TAXOFF
Remove Tax from line Item
TAXERR
Invoiced PST or GST does not match calculated PST or GST when Vendor Submitted amount is paid
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Invoiced PST or GST does not match calculated PST or GST when Vendor Submitted amount is paid
NAMERR
BRN submitted does not match the clients surname in CHRIS
Date: October 23, 2009
23
Community Care Access Centre (CCAC)
Version:
2.10
Billing RA Report Format Specification
Version Date: October 23 2009
4. Appendix B - Service Delivery Type
The following table provides the Service Delivery Type Code, as well as Specialty, Unit of Delivery, and
Service Location, by Service Type Code
Table 1 Correlating Service attributes
Service
Type
Service Delivery Type Code
Specialty
Unit of
Delivery
Service Location
ENT
ENT
ENT
ENT
Children’s Treatment Network
Referrals
Visit dietician - Children's
Treatment Network
Visit OT - Children's Treatment
Network
Visit PT - Children's Treatment
Network
Hourly speech - CTN
Visit speech - Children's Treatment
Network
Visit social work - Children's
Treatment Network
Home Care Referrals
Ambulance trip - one way
Hourly attendant care
Visit attendant care
Visit Adult Day Program accessed
via CCAC
Hourly ENT home care
Hourly ENT Palliative Home Care
Visit ENT combined nursing &
therapy day clinic
Visit ENT combined nursing &
therapy day/night clinic
Visit ENT home care
Visit ENT nursing only clinic
Visit ENT Palliative Home Care
ENT
Visit ENT primary care practice
Visit
ENT
Visit ENT Residential Hospice
Hourly Children's Enhanced Respite
home care
Visit Psychogeriatric Resource
Coordination home care
Hourly Homemaking - Caregiver
Respite home care
Hourly Homemaking - Combined
personal support & housekeeping
Visit
Home Care
Home Care
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Nursing Day Clinic
Home Care
Primary Care
Practice
Residential
Hospice
Hour
Home Care
Visit
Home Care
Hour
Home Care
Hour
Home Care
NUT
OT
PT
SP
SP
SW
AMB
AT
AT
DP
ENT
ENT
ENT
ER
GER
HOM
HOM
Date: October 23, 2009
Palliative
Visit
Home Care
Visit
Home Care
Visit
Hour
Home Care
Home Care
Visit
Home Care
Visit
Home Care
Visit
Hour
Visit
Home Care
Home Care
Home Care
Visit
Hour
Hour
Visit
Palliative
Homemaking –
Caregiver Respite
Combined Personal
Support and
24
Visit
Visit
Visit
visit
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Service
Type
HOM
HOM
HOM
HOM
HOM
HOM
HOM
LAB
MOW
Service Delivery Type Code
home care
Hourly Homemaking - Housekeeping
home care
Hourly Personal Support Home Care
Hourly Personal Support Residential
Hospice
Visit Homemaking - Combined
home care
Visit Homemaking - Housekeeping
home care
Visit Homemaking - Respite home
care
Specialty
Housekeeping
Homemaking Housekeeping
Homemaking Personal Support
Homemaking Personal Support
Combined Personal
Support and
Housekeeping
Homemaking Housekeeping
Homemaking Caregiver Respite
Homemaking Personal Support
2.10
Unit of
Delivery
Hour
Home Care
Hour
Hour
Home Care
Residential
Hospice
Visit
Home Care
Visit
Home Care
Visit
Home Care
Visit
Visit
Visit
Home Care
Home Care
Home Care
Hour
Visit
Hour
Home Care
Home Care
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Nursing Day Clinic
Home Care
Phone
Primary Care
Practice
Residential
Hospice
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Home Care
Home Care
Nursing Day Clinic
Home Care
Phone
Primary Care
Practice
NUR
NUR
NUR
NUR
NUR
Visit Personal Support home care
Visit Lab home care
Meals on Wheels CCAC
Hourly Nurse Practitioner home
care
Visit Nurse Practitioner home care
Hourly nursing home care
Shift nursing combined therapy &
nursing day clinic
Shift nursing combined therapy &
nursing day/night clinic
Shift nursing home care
Shift nursing nursing only day clinic
Shift Nursing Palliative Home Care
Shift nursing phone call
NUR
Shift nursing primary care practice
Hour
NUR
Hour
NUR
NUR
NUR
NUR
NUR
NUR
NUR
Shift Nursing Residential Hospice
Visit nursing combined therapy &
nursing day clinic
Visit nursing combined therapy &
nursing day/night clinic
Visit nursing Continence home care
Visit nursing home care
Visit nursing IV home care
Visit nursing nursing only day clinic
Visit Nursing Palliative Home Care
Visit nursing phone call
NUR
Visit nursing primary care practice
NP
NP
NUR
NUR
NUR
Date: October 23, 2009
Hour
Palliative
Hour
Hour
Hour
Hour
Hour
Visit
Nursing - Continence
Nursing - IV
Palliative
Visit
Visit
Visit
Visit
Visit
Visit
Visit
Visit
25
Service Location
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Service
Type
NUR
NUT
NUT
NUT
NUT
NUT
NUT
Service Delivery Type Code
Visit nursing Wound Care home
care
Hourly dietician home care
Visit dietician phone call
Visit dietician combined nursing &
therapy day clinic
Visit dietician combined nursing &
therapy day/night clinic
Visit dietician home care
Specialty
Nursing - Wound Care
2.10
Unit of
Delivery
Visit
Hour
Visit
Visit
Visit
Visit
Service Location
Home Care
Home Care
Phone
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Residential
Hospice
Visit Dietician Residential Hospice
Visit dietician therapy only day
clinic
Visit OT phone call
Visit OT combined nursing &
therapy day clinic
Visit OT combined nursing &
therapy day/night clinic
Visit OT home care
Visit OT home care hourly
Visit
Visit
Visit
Visit
Hour
Home Care
Visit
Visit
Visit
Visit
Visit
Home Care
Home Care
Home Care
Home Care
Phone
Visit
Visit
Hour
Home Care
Home Care
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Phone
PT
Visit OT Residential Hospice
Visit OT therapy only day clinic
Visit Pastoral Care home care
Hourly Pharmacy Consultation
home care
Visit Pharmacy Consultation home
care
Visit Physician home care
Visit Physician Palliative Home Care
Visit paramedical
Pain & Sympton Mgmt phone call
Visit Pain & Sympton Mgmt home
care
Visit Psychologist home care
Hourly PT home care
Visit PT combined nursing &
therapy day clinic
Visit PT combined nursing, therapy
day/night clinic
Visit PT home care
Visit PT phone call
Visit PT Pulmonary Rehab Home
Care
Therapy Day Clinic
Phone
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Home Care
Residential
Hospice
Therapy Day Clinic
Home Care
PT
Visit PT Residential Hospice
NUT
OT
OT
OT
OT
OT
OT
OT
PAS
PHA
PHA
PHY
PHY
PM
PSM
PSM
PSY
PT
PT
PT
PT
PT
Date: October 23, 2009
Visit
Visit
Visit
Visit
Visit
Hour
Palliative
Visit
Visit
Visit
Visit
PT - Pulmonary
Rehab
Visit
Visit
26
Home Care
Residential
Hospice
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Service
Type
PT
RT
Service Delivery Type Code
RT
RT
Visit PT therapy only day clinic
Hourly RT home care
Visit RT combined nursing, therapy
day clinic
Visit RT combined nursing, therapy
day/night clinic
Visit RT home care
RT
RT
SH
SP
SP
Visit RT Residential Hospice
Visit RT therapy only day clinic
Supportive Housing
Hourly speech home care
Hourly speech therapy clinic
SP
Visit Communicate Device Assistant
Home Care
RT
SP
SP
SP
SP
SP
SP
SP
SW
Visit speech augmentative
communication home care
Visit speech combined nursing,
therapy day clinic
Visit speech combined nursing,
therapy day/night clinic
Visit speech home care
Visit speech phone call
Specialty
2.10
Unit of
Delivery
Visit
Hour
Visit
Visit
Visit
Hour
Hour
Therapy Day Clinic
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Residential
Hospice
Therapy Day Clinic
Home Care
Home Care
Therapy Day Clinic
Visit
Home Care
Visit
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Phone
Residential
Hospice
Therapy Day Clinic
Home Care
Combined Day
Clinic
Combined
Day/Night Clinic
Home Care
Phone
Residential
Hospice
Therapy Day Clinic
Home Care
Visit
Visit
Visit
Speech Communicative
Device Assistant
Speech Augmentative
Communication
Visit
Visit
Visit
Visit
Visit speech Residential Hospice
Visit speech therapy only day clinic
Hourly social work home care
Visit social work combined nursing,
therapy day clinic
Visit social work combined nursing,
therapy day/night clinic
Visit social work home care
Visit social work phone call
Visit social work Residential
Hospice
Visit social work therapy clinic
Transportation home care
School Referrals
Visit
Visit
Hour
Visit
HOM
Visit ENT private/home school
Hourly Personal Support
Private/Home School
NUR
Hourly nursing private/home school
SW
SW
SW
SW
SW
SW
TRANS
ENT
Date: October 23, 2009
Visit
Visit
Visit
Visit
Visit
Visit
Visit
Homemaking Personal Support
Hour
Hour
27
Service Location
Private/Home
School
Private/Home
School
Private/Home
School
Community Care Access Centre (CCAC)
Version:
Billing RA Report Format Specification
Version Date: October 23 2009
Service
Type
Service Delivery Type Code
Specialty
2.10
Unit of
Delivery
NUR
Hourly nursing public school
Hour
NUR
Shift nursing private/home school
Hour
NUR
Shift nursing public school
Hour
NUR
Visit nursing private/home school
Visit
NUR
Visit
NUT
Visit nursing public school
Hourly dietician private/home
school
NUT
Hourly dietician public school
Hour
NUT
Visit dietician private/home school
Visit
NUT
Visit dietician public school
Visit
OT
Hourly OT private/home school
Hour
OT
Hourly OT public school
Hour
OT
Visit OT private/home school
Visit
OT
Visit OT public school
Visit
PT
Hourly PT private/home school
Hour
PT
Hourly PT public school
Hour
PT
Visit PT private/home school
Visit
PT
Visit PT public school
Visit
SP
Hourly speech private/home school
Hour
SP
Hourly speech public school
Hour
SP
Visit speech private/home school
Visit
SP
Visit speech public school
Visit
Date: October 23, 2009
Hour
28
Service Location
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School
Private/Home
School
Publicly Funded
School