Start the registration six to eight weeks before your first billable day, because it involves a mailed ministry letter and cannot be rushed. Expect a gap of several weeks between your first shift and your first deposit. And know that from day one the rejections are yours: nothing in the system chases them for you, and a claim nobody corrects simply expires.
IntelAGENT is free for your first three months, which is roughly the gap before your first steady deposits. See how →
This page assumes you are finishing training in Ontario and about to bill for your own work for the first time. It does not cover the mechanics of registration in detail — how to start billing OHIP and MCEDT registration do that. What it covers is the timing, and the things that only go wrong in a first year.
The thing nobody tells you: it runs on weeks
Every step of the setup involves someone other than you:
-
CPSO registration and your billing number
You cannot bill without being licensed to practise, and the billing number follows from registration. This is the part most people have in hand already.
-
GO Secure account and ministry enrolment
Online, and the fastest part.
-
The ministry's registration letter
Mailed. This is the step that sets the clock, and no amount of urgency changes it. If you take one thing from this page, it is that you cannot compress this step, so start it early.
-
Designating your billing software
Once enrolled, you authorise whoever submits on your behalf. Quick, but it cannot happen before the step above.
Six to eight weeks ahead of your start date is comfortable. Four is tight. Starting in your first week of work means billing for several weeks of care retroactively, which is legal and routine but is also exactly the situation in which encounters go unrecorded.
You can treat patients before you can submit claims. Those services are still billable — within the submission window, counted from the service date, not from the date your setup finished. So write down what you did, from day one, in whatever form you can. A list of dates, patients and services on your phone is worth real money later.
Your first payment is further away than you think
Claims are adjudicated in monthly payment runs. A claim submitted after a run's cut-off waits for the next one, and the deposit follows the run. Stack that on top of a setup that finished partway through a month, and the gap between your first shift and your first money can be six to eight weeks.
Practical consequences:
- Plan for the gap. Moving cities, starting a practice and buying equipment at the same time as a two-month income gap is the predictable squeeze of a first year.
- Submit continuously, not monthly. Claims sent as the work happens catch the earliest run they can. Claims saved up for a month-end push systematically land after a cut-off.
- Do not read the first deposit as a verdict. It covers whichever claims made that run, not all of them. Reconciling it against what you expected is how you learn what the number means — see reading a Remittance Advice.
Settle the arrangement in writing
If you are joining a group, a hospital department or a clinic, find out before you start:
- Whether claims go out under a group number, and which one. Payment goes to the group, not to you, and how the group pays you is a separate agreement. Group billing covers what else changes.
- Who submits. You, or an administrator on your behalf. Either is fine; not knowing is not.
- Who works rejections, and how you find out about them. This is the question people forget, and it is the one that costs money.
- The facility numbers for every site you will work at.
- Whether you need to be added to the group on the ministry side before claims under its number will be accepted. Claims for a physician the ministry does not have on record for that group are refused.
If you are doing locum work before settling somewhere, billing as a locum is the relevant page.
What goes wrong in a first six months
-
Nobody is working the rejections
The most expensive mistake, every time. Residency has no equivalent — there was always someone else responsible for the administrative consequence of your work. There is not now. A rejected claim sits until someone corrects it, and then expires. Look at your rejections weekly, from the first week.
-
Under-coding out of caution
New physicians systematically bill the lower assessment code when the higher one was performed, because the higher one feels like a claim they would have to defend. Bill what you did. The Schedule defines each code by the service rendered, and billing below it is not prudence, it is a donation.
-
Premiums never billed at all
Nights, weekends and call-ins carry premiums that are not prompted by the base code. Most new physicians do not know they exist for the first year. See special visit premiums.
-
Assuming someone else is checking
If an administrator submits for you, they submit what you give them. They cannot bill a service you never recorded, and they usually cannot tell that you did not record it.
-
No sense of what a month should be worth
Without a rough expectation, any deposit looks plausible. The first useful instinct to build is what a normal week of your own practice produces, because it is the only thing that makes a bad month visible.
Learn your specialty's codes, not all of them
The Schedule of Benefits is enormous and you will use a tiny fraction of it. Most physicians bill a dozen or two codes for the overwhelming majority of their work.
Finding your dozen quickly beats reading the Schedule cover to cover. The specialty pages list the codes billed most often in emergency medicine, internal medicine, psychiatry, anaesthesia, general surgery, obstetrics and gynaecology, paediatrics and family practice, with what tends to get missed in each.
Your first year on IntelAGENT
The first year is the one where you do not yet know what you should be billing, and the one where a missed setup step costs months of cash flow.
- Three months free. The first three months are free, which covers roughly the period before your first steady deposits.
- 0.25% capped at $39.99 a month. Self-service pricing is a percentage of paid claims with a monthly cap, so a slow first month costs very little.
- Rejections surfaced with the reason. Not filed in a report you have to go and read.
- Premium prompting. Eligible premiums are offered rather than remembered, which matters most in the year when you do not yet know they exist.
- Mobile capture. Recording a service during the shift on the phone app, including before your submission setup is complete.
Three months free, then 0.25% of paid claims, capped at $39.99 a month. IntelAGENT has submitted OHIP claims since 2016 for more than 2,000 Ontario physicians.
Frequently asked questions
When should I start setting up OHIP billing?
Before your first billable shift, and earlier than feels necessary. Registration involves the ministry and a mailed letter, so it runs on weeks rather than days. Starting six to eight weeks ahead is comfortable; starting the week you begin work is not.
How long until a new physician gets their first OHIP payment?
Longer than one month. Claims are adjudicated in monthly payment runs, so a claim submitted mid-month may sit until the next run, and the deposit follows the run. Budget for a gap of several weeks between your first shift and your first deposit.
Do I need my own billing number if I am joining a group?
Yes. The billing number identifies you as the physician who rendered the service, and it is yours regardless of whether payment goes to you or to a group. A group number sits alongside it; it does not replace it.
What do new physicians get wrong most often?
Not billing at all for the first few weeks while setup is pending, and then discovering the work still has to be claimed within the submission window. Second is never looking at rejections, because nobody told them rejections were their responsibility.
Sources
- Ministry of Health — physician payment.
- Ministry of Health — MCEDT — registration and designation.
- OHIP Schedule of Benefits and Fees.
Related reading
How to start billing OHIP
The full sequence from billing number to first paid claim.
GuideMCEDT registration
GO Secure, the registration letter, and the designee step.
GuideBilling deadlines
Why work done before your setup finished is still billable.
ProductPricing
0.25% of paid claims, capped at $39.99 a month. First three months free.