Billing Guard
Every claim AgileRx produces passes through Billing Guard twice: before submission, against the rules HNS enforces, and after payment, against the documentation a ministry verification will ask for.
What it does
In the pharmacist’s words.
Named rules against real HNS response codes — benefit maximum reached (LO), same-day duplicate (A3), late submission, and incomplete documentation.
The cross-module rule no point solution can enforce: a MedsCheck Follow-up (PINs 93899981–84) and a prescription-issuing minor ailment assessment on the same patient on the same day is a prohibited combination. AgileRx knows, because it runs both.
Thresholds live in a rules table, not in code. When the ministry changes a fee or a maximum, that is a data update — not a software release you wait for.
Assist, never obstruct. Billing Guard surfaces the finding and the pharmacist decides. It does not silently block a claim.
The edge
A claim scrubber that only sees one service can only catch one service’s mistakes. Billing Guard sees the whole clinical day.
Sources
Every fee, PIN, code and date on this page traces to a published ministry or College document. When one of them changes, the rules table changes with it.
- Health Network System response codes (LO, A3).
- Ontario Drug Programs Reference Manual, claims submission and verification.
See Billing Guard on a real clinical day.
Billing Guard does not ship alone — it runs on the same patient record as the other six modules, which is what lets AgileRx catch the things a single-service tool never sees. Book thirty minutes and we will walk the whole day, not the demo.