Health claims are claims for services rendered by physicians or private medical labs to a patient with Ontario health coverage.
Note : Payee is dependent on whether you opted in or opted out when you registered.
- Payment program "HCP".
- Payee - "P" for pay provider.
- Payee - "S" for pay patient.
Workplace Safety and Insurance Board (former Workers' Compensation Board (WCB)) claims are for services rendered to patients with Ontario health coverage who have work related injuries.
Note : Other than the payment program, the information required to bill is the same as for HCP claims.
- Payment program is WCB.
- Payee is "P" for pay provider.
- If the patient is assessed for a non-WCB related problem during a WCB visit (minor assessment only), A008A (Mini Assessment) may be payable. Refer to the Schedule of Benefits, sections General Preamble and Consultations and Visits
- A008A cannot be billed on the same claim as the WCB service. It must be billed on a separate HCP claim. A008A can be billed only when the WCB claim is for A001A.
- If the physician bills any service on a WCB claim other than a minor or partial assessment, no other assessment can be submitted as an HCP (MOH) claim.