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Ontario Health Insurance Plan

OHIP Bulletins


INFOBulletin

Keeping Health Care Providers informed of payment, policy or program changes

Primary Health Care Services InfoBulletins

To: Eligible Patient Enrolment Model Physicians
  • Blended Salary Model (BSM)
  • Comprehensive Care Model (CCM)
  • Family Health Group (FHG)
  • Family Health Network (FHN)
  • Family Health Organization (FHO)
  • Group Health Centre (GHC)
  • HIV AFP Model (HIV)
  • Rural and Northern Physician Group Agreement (RNPGA)
  • St. Joseph's Health Centre (SJHC)
  • South Eastern Ontario Academic Medical Association (SEAMO)
  • Weeneebayko Area Health Authority (WAHA)

Published by:  Negotiations Branch

Date Issued: April 10, 2017

Bulletin Number:  11173

Re: 2016-17 Cumulative Preventive Care Bonus Information

Posted Electronically Only

PDF Version Portable Document Format | 129 Kb


Physicians may now submit for their 2016/2017 Cumulative Preventive Care Bonuses. The ministry has provided all PEMs with the following information to assist with the calculation and submission of their Cumulative Preventive Care Bonuses:

  • Information and Procedures for Claiming the Cumulative Preventive Care Bonus (Revised March 2017),
  • A Preventive Care Target Population/Service Report (TPSR) for the 2016/2017 fiscal year, and
  • A TPSR with projected patient information for the 2017/2018 fiscal year.

Please note that FHG and CCM physicians who did not meet the minimum roster size will receive a TPSR with projected patient information for the 2017/2018 fiscal year. A letter has also been sent to these physicians advising them of the minimum roster size requirements and encouraging them to continue to enroll patients to ensure they meet the minimum roster requirements for the 2017/2018 fiscal year.

Claims submission for Eligible Physicians

As regular stale-dating rules will apply, please ensure your bonus claims are submitted prior to the claims processing cut-off date in September 2017. Only claims for these five (5) bonus categories received on or prior to the cut-off date are guaranteed to be processed for payment.

Physicians who have changed billing software need to ensure they can submit Preventive Care Bonus claims without a health number, version code or date of birth. If your software does not allow for this submission please contact your software vendor for an update.

Please note that eligible physicians should submit bonus claims using the normal billing practices used to submit Fee for Service claims. Details for submitting bonus claims are included in the enclosed Information for Procedures for Claiming the Cumulative Preventive Care Bonus document.

For any inquiries please contact the Service Support Contact Centre: 1-800-262-6524 or SSContactCentre.MOH@ontario.ca


To view Portable Document Format PDF files, you will need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe website.

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