Why Alberta first

Zorva started as an Ontario-pivot idea. We had OHIP fee schedules memorized, an Ontario PCN analog (the FHT) on the shortlist, and a half-built prompt tuned for OHIP-specific modifier rules.

Then we looked at the Alberta AHCIP fee schedule, talked to six Alberta billers, and realized the entire competitive landscape was different.

What we heard from Alberta billers

Across the six biller interviews (March-May 2026), the common threads were:

• The denial-rate ceiling is real. Alberta billers described denial rates between 4% and 12%, with the median around 7.5%. Most of the denials are not random — they cluster around specific patterns (modifier-25, telehealth consent, dx-linkage, CMGP-vs-focused-visit).
• The submission-service options are weak. Three of the six billers had tried managed submission in the past two years and reverted to in-house. The reasons were consistent: cost (12-18% of recovered revenue is too much), loss of control (the service didn't escalate the way the clinic wanted), and audit-defensibility (the clinic couldn't verify the service's work after the fact).
• EMR billing modules are not the answer. Telus PS Suite, OSCAR, Accuro, and Med Access all have billing modules, but the billers described them as "a checkbox on the encounter screen" — not a tool that reads the clinical note. The biller is still the one catching the modifier-25 misses and the dx-linkage errors.

Why Alberta specifically

Three reasons:

1. The fee schedule is well-defined and versioned. Alberta Health publishes the SOMB (Schedule of Medical Benefits) on a quarterly cadence with a clear changelog. The ruleset Zorva builds against has a stable, citable source.
2. The HIA framework is the gold standard. Alberta's Health Information Act is one of the strongest privacy frameworks in North America. The HIA Information Manager Agreement (IMA) template that Zorva signs with Alberta clinics is the same one used by Alberta Health Services. For clinics that already operate under HIA, the compliance path is short.
3. PCN density is high. Alberta's Primary Care Networks cover most family physicians in the province. The PCN central-office admin is the buyer for many clinics, and PCNs already run centralized billing-quality programs. Zorva slots into an existing program structure rather than asking the clinic to build a new one.

What about OHIP and MSP?

Ontario (OHIP) and British Columbia (MSP) are on the 2027 roadmap. The prompt architecture is jurisdiction-agnostic — the ruleset is the only thing that changes between AHCIP, OHIP, and MSP. We're building the v12 ruleset for AHCIP first, and the OHIP/MSP rulesets will be forks once the v12 AHCIP prompt is in production.

What this means for you

If you're an Alberta clinic or PCN, Zorva is built for you. If you're in Ontario or BC and want to be on the early-access list for the OHIP/MSP rulesets, send a note via /contact and we'll add you.