Skip to content
RAMQ billing · Emergency medicine

Your AI
billing agent.

It reviews your notes, finds the services you missed and submits your shift to RAMQ.

Try it freeSee it at work

Example: in a note, the sentence “Admitted to internal medicine, still in the ED for lack of a bed upstairs” becomes service 15637, Admitted patient supplement.

What it does for you

You care for patients.
It takes care of the billing.

  1. 1It reviews every note.And finds the services you haven’t billed.
  2. 2It suggests the right code.Based on the patient’s age and the time. One tap, and it’s added.
  3. 3It compares the different ways to bill.Complex situation or visits: everything is calculated, you choose.
  4. 4It submits to RAMQ and handles refusals.The response arrives live. A refusal comes back with its correction.
Your AI

It reviews, it corrects,
it answers.

You confirm each step with a tap.

It finds the unbilled services in your notes.

It finds the rule and prepares the correction.

It cites its sources and prepares the claim.

The RAMQ library

  • Billing manualManual
  • Code directoryCodes
  • Brochures and agreementsBrochures
  • Billing guideGuide
  • NewslettersNewsletters

Your note C10 · Chen, Wei · 03:35

Admitted to internal medicine, still in the ED for lack of a bed upstairs. Febrile at 38.6. Bedside focused ultrasound: normal-calibre aorta, no free fluid. Difficult Foley insertion, second attempt: 900 mL of cloudy urine.

3 services added to the visit

What it suggests

  1. Admitted to internal medicine, still in the ED for lack of a bed upstairs15637Admitted patient supplementAdded
  2. Bedside focused ultrasound: normal-calibre aorta, no free fluid00689Emergency focused ultrasoundAdded
  3. Difficult Foley insertion, second attempt: 900 mL of cloudy urine00302Emergency bladder catheterizationAdded
C5Fortin, AndréanneAdmissible

Corrected and sent again : The billed code is incompatible with another code you billed the same day.

Your AI agent is looking at this refusal.

YOUR AI AGENT

RAMQ read a principal examination at 9:18 p.m. and a complex situation at 11:50 p.m., on the same day, for this patient.

Did she come back for another stay?

Yes, another stayNo, the same stay

Correction prepared

Line
11:50 p.m. · Complex situation
Before
no context
After
87 Different emergency room stay
Admissible

Your question · 3:56 p.m.

How do I bill a cardiac arrest with intubation?

I search “cardiopulmonary resuscitation” (RAMQ texts)I look up code 00828 in the RAMQ code referenceI check each sentence against the text it cites0 sWhat the agent did · 14.0 s ⌄

The cardiopulmonary resuscitation code and, when the conditions allow, the intubation code.RDRégie de l’assurance…

  • Cardiopulmonary resuscitation: code 00828 for the first quarter hour, then code 00829 for each additional quarter hour.RDRégie de l’assurance…
  • Endotracheal intubation alone: code 00182.RDRégie de l’assurance…
  • During the resuscitation: 00828 includes “any other medical service provided during the manoeuvre”. An intubation done at that time is not billed separately.RDRégie de l’assurance…

Follow-up question · 3:58 p.m.

Bill the trauma committee from yesterday morning, started at 9 a.m. I attended for one hour.

I look for the activity to billI read the form “An emergency department committee”0 sWhat the agent did · 5.0 s ⌄

To bill your participation, I need one detail. How many flat fees were you allotted?

Flat fees allotted?

1 flat feeI don’t know

I prepared the claim for your trauma committee from yesterday morning.

Claim prepared · An emergency department committee

19885 Medical-clinical committees · morningTuesday, October 20 · 9 to 10 a.m. · 1 flat feeSendingReceived by RAMQ

It is recorded.

Create the claimSet asideSend to RAMQSee on the Off-shift page
Your billing question↑

The services
that go unbilled.

With the RAMQ library on one side and your note on the other, your agent quickly spots what can be billed. A few examples.

Wounds and skin

  • Wound repair
  • Incision and drainage of an abscess
  • Subungual hematoma
  • Foreign body removal
  • Burn treatment
  • Ingrown nail

Bones and joints

  • Closed reduction of a fracture
  • Reduction of a dislocation
  • Cast or splint immobilization
  • Joint aspiration
  • Injection
  • Tendon repair

Resuscitation

  • Intubation
  • Cardioversion
  • External cardiac pacing
  • Chest tube
  • Central line
  • Intraosseous access

At the bedside

  • Emergency focused ultrasound
  • Procedural sedation and analgesia
  • Nerve block
  • Lumbar puncture
  • Paracentesis
  • Nasal packing for epistaxis

Supplements and special services

  • Admitted patient seen again in the ED
  • Accompanied ambulance transfer
  • Pronouncement of death
  • Preventive confinement
  • Medico-legal kit
  • Communication through an interpreter
Your billing
1 · During the visit

The right code,
with a single tap.

A fictional shift on Saturday, September 12, from 20:00 to 04:00: thirteen patients, their visits and their codes, billed during the shift, then the number of codes for each patient, for the shift, and Submit. Tap any patient to open their billing card.

The shift
2 · The different ways to bill

Complex situation,
or visits?

AtomicMD calculates both and shows you the better one.

3 · At the end of the shift

Your shift is over.
So is your billing.

One tap, and RAMQ answers live.

Submit the shift · AtomicMD Hospital

Responses from RAMQ13 admissible

  1. C7Pelletier, Micheline 3 codesAdmissible
  2. C12Boucher, Simon 2 codesAdmissible
  3. C5Fortin, Andréanne 2 codesAdmissible
  4. C14Nadeau, Karim 4 codesAdmissible
  5. C1Ouellet, René 2 codesAdmissible
  6. C3Gagnon, Robert 2 codesAdmissible
  7. C11Thibodeau, Louise 2 codesAdmissible
  8. C4Bélanger, Roger 4 codesAdmissible
  9. C9Lavoie, Julien 2 codesAdmissible
  10. C2Tremblay, Émilie 1 codeAdmissible
  11. C6Côté, Louis 3 codesAdmissible
  12. C10Chen, Wei 6 codesAdmissible
  13. C13Morin, Audrey 1 codeAdmissible
Done
4 · Outside your shifts

Committees, teaching,
availability.

Each activity has its form, and RAMQ answers under the line.

Off-shiftWhat you bill apart from your on-site shifts.
?
committeeSearch: committee, CMDP, coroner, SAAQ…

All, by family

  • A patient seen while not on shiftA patient, outside your shift›
  • A long clinical interventionA patient, outside your shift›
  • A clinical exchange by phoneA patient, outside your shift›
  • A telephone consultationA patient, outside your shift›
  • A call for an emergency outside the emergency roomA patient, outside your shift›
  • A toxicology or hyperbaric medicine consultationA patient, outside your shift›
  • A patient in intensive care, in an open unitA patient, outside your shift›
  • An emergency department committeeMeetings and administrative roles›
  • Your activities as emergency department head or assistantMeetings and administrative roles›
  • A CMDP meetingMeetings and administrative roles›
  • Head of the general medicine department or assistantMeetings and administrative roles›
  • A clinical project entrusted by the institutionMeetings and administrative roles›
  • Medical advisor for the CISSS or CIUSSSMeetings and administrative roles›
  • Your medical-administrative activitiesMeetings and administrative roles›
  • Head of the DRMGMeetings and administrative roles›
  • DRMG management committee, local table or mandateMeetings and administrative roles›
  • Local coordinator of front-line servicesMeetings and administrative roles›
  • A recognized national organizationMeetings and administrative roles›
  • Medical advisor invited in public healthMeetings and administrative roles›
  • Supervising a residentTeaching and supervision›
  • Supervising an externTeaching and supervision›
  • Supervising an NP in trainingTeaching and supervision›
  • Clinical supervision outside the emergency roomTeaching and supervision›
  • TeachingTeaching and supervision›
  • Simulation teachingTeaching and supervision›
  • Teaching in a clinic or a GMF-UTeaching and supervision›
  • An assessment for preventive confinementAssessments and reports›
  • A psychiatric assessment, provisional confinementAssessments and reports›
  • Keeping a person confined in an institutionAssessments and reports›
  • An assessment for a treatment or housing orderAssessments and reports›
  • Follow-up of a treatment or housing orderAssessments and reports›
  • An accused person's fitness to stand trialAssessments and reports›
  • Criminal responsibilityAssessments and reports›
  • An assessment for the review boardAssessments and reports›
  • A release application before the Tribunal administratifAssessments and reports›
  • An assessment for a protective measureAssessments and reports›
  • Youth criminal justiceAssessments and reports›
  • Youth protectionAssessments and reports›
  • A report to the DPJAssessments and reports›
  • A communication to assess dangerousnessAssessments and reports›
  • Testifying in court or before the Tribunal administratifAssessments and reports›
  • Testifying in court or at a coroner's inquestAssessments and reports›
  • A reserved psychiatric assessmentAssessments and reports›
  • A CNESST formForms, without a new visit›
  • A verbal reportForms, without a new visit›
  • An opinion before consolidationForms, without a new visit›
  • A supplementary reportForms, without a new visit›
  • A reasoned consultation reportForms, without a new visit›
  • An assessment report after consolidationForms, without a new visit›
  • An assessment as a designated physicianForms, without a new visit›
  • A complexity consideration grantedForms, without a new visit›
  • The Bureau d’évaluation médicaleForms, without a new visit›
  • A preventive withdrawal certificate for a pregnant workerForms, without a new visit›
  • A temporary assignmentForms, without a new visit›
  • Review of a particular fileForms, without a new visit›
  • An additional opinionForms, without a new visit›
  • A scheduled assessment that did not take placeForms, without a new visit›
  • A toxicology supplement to a reportForms, without a new visit›
  • A professional diver certificateForms, without a new visit›
  • A certificate, a progress report or a final reportForms, without a new visit›
  • An assessment report on after-effectsForms, without a new visit›
  • A financial assistance reportForms, without a new visit›
  • A report for the Public CuratorForms, without a new visit›
  • A qualified physician certificate and a legal sampleForms, without a new visit›
  • A certificate of exposure to a contaminantForms, without a new visit›
  • An examination required for employment by a Québec lawForms, without a new visit›
  • A report for the SAAQ, at the patient's requestForms, without a new visit›
  • A private insurer or employer form, outside CNESSTForms, without a new visit›
  • A form already included in an insured serviceForms, without a new visit›
  • On-call availability at the CLSCAvailability›
  • On-call availability for the local networkAvailability›
  • Availability for admitted patientsAvailability›
  • Obstetrics availabilityAvailability›
  • Regional availability for victims of sexual assaultAvailability›
  • Sub-regional availability for victims of sexual assaultAvailability›
  • On-call supportAvailability›
  • Local on-call at the UHBAvailability›
  • Intensive care availabilityAvailability›
  • Presence in intensive care (unit flat rate)Availability›
  • Trauma team leader availabilityAvailability›
  • The pediatric transport head supplementAvailability›
  • Time in the outpatient clinic or with admitted patientsOutside the emergency room›
  • Time and expenses for an authorized locum coverageTravel, prehospital, ÉVAQ›
  • An authorized replacement or supportTravel, prehospital, ÉVAQ›
  • Regional travel timeTravel, prehospital, ÉVAQ›
  • Management, quality, training, committeesTravel, prehospital, ÉVAQ›
  • The support shift at the base hospitalTravel, prehospital, ÉVAQ›
  • Advice to paramedics, a transmitted ECG or a remote death certificationTravel, prehospital, ÉVAQ›
  • Remote medical support during an on-site shiftTravel, prehospital, ÉVAQ›
  • Medical control: programming or interventionsTravel, prehospital, ÉVAQ›
  • Medical control availabilityTravel, prehospital, ÉVAQ›
  • An escortTravel, prehospital, ÉVAQ›
  • The mission flat rateTravel, prehospital, ÉVAQ›
  • Supervision during an escortTravel, prehospital, ÉVAQ›
  • Helicopter transport trainingTravel, prehospital, ÉVAQ›
  • Availability before your escort shiftTravel, prehospital, ÉVAQ›
  • Interventions during phone availabilityTravel, prehospital, ÉVAQ›
  • On-site interventionsTravel, prehospital, ÉVAQ›
  • Head of the ÉVAQ service, neonatology rotationTravel, prehospital, ÉVAQ›
  • Toxicology programmingTravel, prehospital, ÉVAQ›
  • Provincial toxicology coverageTravel, prehospital, ÉVAQ›

Results

  • An emergency department committeeMeetings and administrative roles›
  • DRMG management committee, local table or mandateMeetings and administrative roles›
  • Management, quality, training, committeesTravel, prehospital, ÉVAQ›

‹ Off-shift

An emergency department committeeAtomicMD Hospital
?
CommitteeOngoing review of the emergency department management process
DateTuesday, October 20
Time of dayMorningAfternoon or evening
StartHH:MM13:00
Your participation−1 h1 h 30+
Flat fees allotted−12+
Add
Sending to RAMQAtomicMD Hospital
An emergency department committeeTuesday, October 20 · 1:00 to 2:30 p.m. · 2 flat feesSendingReceived by RAMQ
Sending…Done
Charles Kalash, emergency physician and founder of AtomicMD
The agency

An agency in good standing.
Built by an emergency physician.

“ Because our time should go to exercising our judgment, caring for patients and being present for them. ”

Charles KalashEmergency physician and founder of AtomicMD

To begin

Changing agencies?
Everything is done from the app.

Three steps, and the app guides you through each one.

  1. 1

    You sign the agreement.

    In the app, on screen.

  2. 2

    You entrust us with your account.

    In your name
    A few steps in Mon dossier. In effect the next day at 08:00.
    Incorporated
    A signed form, which we check and send for you.
  3. 3

    No interruption.

    Until the switch, your current agency keeps submitting. The day RAMQ confirms it, the app tells you.

4 months free

Until March 5, 2027

All of AtomicMD, no card and no commitment.

Try it free

Then

Based on your use

  • A free version will remain available.
  • Plans starting at $99 per month.
  • Prices will be announced to you in advance.
Try it free
Questions

Before you hand it over

Short answers to questions about billing.

Try it free

Another question? info@atomicmd.ca

The agent and submission

Does AtomicMD send my billing to RAMQ?

Yes. Technologies AtomicMD inc. is registered with RAMQ as a billing agency.

AtomicMD prepares the billing for each shift while you work, and submits it directly to RAMQ once you approve it. Submission begins once your authorization of our agency is signed and confirmed.

How does the agent find the services I missed?

It has the manuals, the code directory and the RAMQ rules at hand. It reviews the note of each visit and suggests the services you haven’t billed, with the sentence from your note.

You add them with one tap.

What happens if RAMQ refuses a line?

Your agent finds the RAMQ rule and prepares the correction. You send the line again with one tap. If needed, a person at the agency takes over.

Can I bill what I do off-shift?

Yes. Committees, teaching, phone consultations, prehospital care, availability: each activity has its form, which only asks for what your file does not already know. A patient seen while not on shift gets a real visit.

How long does it take to change agencies?

If your fees are paid in your name, the change is made in Mon dossier, on the RAMQ site, and it is in effect the next day at 08:00.

If they are paid to your company, RAMQ requires a signed form. We check it and send it for you. Its average time is 25 business days, from a complete request. Until then, your current agency continues.

Do I keep my billing agency?

It is up to you. AtomicMD is itself a billing agency registered with the RAMQ: transmitting your billing is included.

If you prefer to keep your agency, you export your billing to use with your current billing method.

The offer and your data

How much does AtomicMD cost?

Nothing until March 5, 2027: all of AtomicMD is free, billing included. No card is required, and nothing renews on its own.

After that, a free version will remain available, and plans based on your use will start at $99 per month. Prices and terms will be communicated to you in advance, and no payment will be charged without your consent. The details are in the offer section.

Where does my billing data go?

It is hosted and processed in Québec, in the Montréal region. Billing records are kept for your professional and tax obligations, and you can export your data at any time. The details are on the Trust page.

See also

Before billing,
there’s the whole visit.