OHIP billing is not complicated so much as undocumented. The rules exist, in the Schedule of Benefits and in ministry publications, but almost nothing explains the sequence — what to do first, what comes back, and what to do about it when it does.
These guides fill that gap. Each one is self-contained, cites the ministry source it relies on, and says plainly where a rule is specific enough that you should check the current Schedule yourself.
Getting started
How to start billing OHIP
The full sequence from billing number to first paid claim, and the monthly cycle you settle into afterwards.
GuideHow to register for MCEDT
GO Secure, the ministry registration letter, EDT enrolment, and the designee step billing software depends on.
ExplainerWhat is OHIP billing?
Background on how physicians are paid in Ontario, if the whole system is new to you.
GuideBilling for new graduates
What to set up before your first billable day, why the first payment is further off than you think, and the first-year mistakes.
Day-to-day billing
Health card validation in Ontario
What HCV returns, how version codes work, and the rejection family it removes entirely.
GuideOHIP special visit premiums, explained
The travel premium, the per-patient premium, the time bands, and the three rejections premiums produce.
GuideOHIP billing when your hospital runs Epic
Why the hospital EMR does not bill for you, and what a SMART on FHIR launch actually gives you.
GuideOHIP diagnostic codes
Which fee codes require one, the leading-zero problem that silently drops them, and when a wrong code costs money.
GuideBilling deadlines and stale dating
The submission window, the monthly cut-off, and which claims in a practice actually age out.
Getting paid, and finding what was not
Common OHIP claim rejections
EH2, VJ7, EQ6, VH8, V22 and the rest — what stops a claim before adjudication, and the correction that works.
GuideHow to read an OHIP Remittance Advice
The monthly statement, the explanatory codes ranked by how often they appear, and the four checks worth doing.
GuideHow to reduce missed OHIP billings
The six places revenue actually leaks, and the order worth fixing them in.
GuideRemittance Advice Inquiry
When to dispute an adjudication rather than resubmit, and what to send with the inquiry.
Practice arrangements
Group billing and group numbers
Where the money goes, which premiums behave differently in a group, and the failures only groups have.
GuideBilling as a locum
Whose number the claims go under, what changes at each site, and the three things to settle before the first shift.
ProductDepartments and groups
How IntelAGENT handles shared group numbers and departmental billing.
GuideWSIB and OHIP
A work injury produces two bills: the service to OHIP under WCB, the forms to WSIB on its own schedule.
Choosing how to bill
How to choose OHIP billing software
Track record, a capped price, a real mobile app, features built from practice, and who works your rejections.
GuideBilling software or a billing agent?
Which half of the job is mechanical, which needs judgement, and what each option costs.
GuideSwitching OHIP billing software
What actually moves, what stays with the ministry, and the sequence that avoids a gap.
CompareCompare OHIP billing software
How IntelAGENT lines up against the other Ontario providers, feature by feature.
Billing by specialty
Fee codes, premiums and the services that go unbilled differ sharply between specialties. The specialty pages cover emergency medicine, internal medicine, psychiatry, anaesthesia, general surgery, obstetrics and gynaecology, paediatrics and family practice.
A note on accuracy
Fee amounts, time bands and ministry processes change. Where a guide names a specific amount or rule, it says when it was accurate and links to the ministry source. Where ordering reflects our own observation of real remittance data rather than a published ranking, it says that too.
Nothing here is a substitute for the OHIP Schedule of Benefits. If a guide and the Schedule disagree, the Schedule is right.