AI billing code suggestions for Alberta physicians
SpecScribe's AHCIP billing review reads the note for an encounter and suggests AHCIP service codes and ICD-10-CA diagnostic codes, each with a confidence level and a short rationale from the note. On Clinical Command Center it also flags possible billing gaps, such as a virtual visit with no virtual-care modifier, or recorded time that may support more units.
The feature is in beta. You check every suggestion against the current Schedule of Medical Benefits and decide what to bill, and SpecScribe doesn't submit claims.
How it works
How the AHCIP code suggestions work
- 1
Start from the note
Run code suggestions on an encounter. SpecScribe uses your edited version of the note when there is one, otherwise the AI draft.
- 2
Identifiers removed first
The patient's name and other known identifiers are removed before the note goes to the AI model, Anthropic's Claude, which runs in the United States.
- 3
Suggestions with reasons
Each suggestion shows the code type (AHCIP or ICD-10-CA), any modifier and units, a confidence percentage and a one-line rationale drawn from the note.
- 4
You accept or reject
Accept or reject each code. Your decisions are kept and logged; running suggestions again replaces only the codes you haven't reviewed yet.
Billing review
What the per-encounter billing review checks
Alongside the code suggestions, the billing review looks for gaps between what's documented and what's about to be billed. Some checks are fixed rules in SpecScribe; others come from the AI reading the note. Every flag says why it was raised.
| Check | What raises it | Source |
|---|---|---|
| Virtual care | The note describes a video or phone visit, but no virtual-care modifier or virtual service code is selected. | Built-in rule |
| Time units | The recorded visit length supports more units of a time-based code than were suggested. Applies only to codes loaded with their unit length. | Built-in rule |
| Unknown code | A suggested code isn't active in the loaded code schedule. Applies only once a schedule has been loaded. | Built-in rule |
| Possible missed service | A service described in the note has no matching code. | AI |
| Complexity | The documented complexity appears higher than the selected code reflects. | AI |
| Modifier | A modifier may apply, for example for after-hours or virtual care. | AI |
Every flag is advisory. The billing review is included on Clinical Command Center and Enterprise Clinic; Solo Scribe includes the code suggestions without the review.
Why beta
What the beta label means
SpecScribe doesn't yet ship a copy of the official fee schedule. Until a current schedule is loaded, suggested codes aren't automatically checked against it, and the AI can suggest a code that is wrong, retired or not billable for your specialty. That's why the feature is labelled beta and why every suggestion needs your check.
Alberta Health publishes the Schedule of Medical Benefits (SOMB), the fee schedule and list of insured medical benefits under the Alberta Health Care Insurance Plan. Check codes, descriptions, governing rules and fees against the current edition linked from Alberta's fees information page.
You remain responsible for what you bill. SpecScribe's suggestions don't replace your own review of the SOMB, AHCIP rules or your documentation, and we don't promise any change in revenue.
Worked example
A worked example on a fictional encounter
Here is what the review shows for a follow-up video visit. Specific fee codes are left out on purpose: check real codes against the current SOMB rather than an example on a web page.
- Note excerpt
- "Follow-up by video visit with Mr. B. (fictional, 52). About 35 minutes spent reviewing mood, sleep and the treatment plan."
- Suggested codes
- One AHCIP service code for the follow-up visit and one ICD-10-CA diagnostic code, each with a confidence percentage and a rationale quoting the note.
- Flag · virtual care (rule)
- Note describes a virtual visit but no virtual-care modifier or virtual service code is selected. Check AHCIP virtual-care billing rules.
- Flag · time units (rule)
- If the suggested code is time-based and loaded with its unit length, SpecScribe compares the recorded time (about 35 minutes) with the units suggested and asks you to confirm documented face-to-face time.
- Your decision
- You compare the suggestions with the SOMB and the note, accept, change or reject them, and submit the claim through your usual billing process.
Who it's for
For Alberta specialists and clinic billers
The billing review is aimed at Alberta physicians who bill AHCIP fee-for-service, and the billers who prepare their claims. It works on the same note you signed, so the evidence for each code is right there.
Billers get their own role in SpecScribe: they can see notes and codes for every encounter in the practice, but not the raw session transcripts.
- Code suggestions cover AHCIP service codes and ICD-10-CA diagnostic codes.
- Other provinces' fee schedules aren't supported today.
- Claims aren't submitted from SpecScribe; you keep your current submission process.
FAQ
Questions about AHCIP billing suggestions
No. SpecScribe suggests codes and flags possible gaps for you to review. You submit claims through your existing billing software or submitter.
Not automatically yet. SpecScribe can flag codes that aren't in a loaded schedule, but no current schedule ships with the product today, so every suggestion needs your check against the current SOMB. That's why the feature is in beta.
It flags places where the documentation may support a different code, more units or a modifier, and shows the evidence. Each flag is a prompt to check, not a recommendation; you decide what the documentation supports.
Solo Scribe ($99 per provider per month) includes AHCIP code suggestions. Clinical Command Center ($149) and Enterprise Clinic add the per-encounter billing review.
Yes. The biller role can see notes and codes for every encounter in the practice, but not raw session transcripts. Access to patient records is audit-logged.
The note text, with the patient's name and other known identifiers removed first. The AI is Anthropic's Claude, which runs in the United States, and the rationale stored with each code is encrypted with AES-256-GCM.
Keep reading
Related pages
Sources
AHCIP billing suggestions are in beta. Suggestions are advisory; the physician remains responsible for every claim. The encounter on this page is fictional. General information, not billing or legal advice.
Last reviewed: 2026-10-20
SpecScribe is not affiliated with or endorsed by Alberta Health or the Alberta Health Care Insurance Plan.
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