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Ministry Status: Routine Monitoring and Engagement

Ontario Health Insurance Plan

OHIP Bulletins


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

To: Primary Health Care Providers

Published by: Claims Services Branch, Ministry of Health and Long-Term Care

Date Issued: February 20, 2018

Bulletin Number: 11186

Re: Adding Detailed Categorization of Claims Report to Medical Claims Electronic Data Transfer (MCEDT)

Posted Electronically Only

PDF Version Portable Document Format | 1 Mb | 

The ministry currently provides and mails out the Detailed Categorization of Claims Report in paper format to Primary Care physicians every month.

In February 2018, the ministry will begin providing this report via MCEDT in two electronic formats, Adobe Portable Document Format (.pdf) and Tab Delimited File. The Tab Delimited File (DCT) will be available the beginning of each month along with the Providers Remittance Advice (RA). The Adobe Portable Document Format (.pdf) (DCP) file will be available starting the second week of every month, after the Payment Summary Report is distributed.

The ministry will continue to provide paper reports for those providers who continue to receive paper Remittance Advices. New and existing providers cannot chose or go back to paper format.

In keeping with the ministry’s technical specifications guideline of providing notices, an OHIP Technical Bulletin 18-001 - Adding Detailed Categorization of Claims Report to Medical Claims Electronic Data Transfer was recently published. If you are having issues viewing the reports in your automated MCEDT software, please use the MCEDT web page https://www.iam.security.gov.on.ca/goID/access to download the reports until your software has been updated.

The “Detailed Categorization of Claims Report - PCCP26R1” was previously added to the manual “Technical Specification for Reports sent via MCEDT” as identified in INFO/Tech Bulletin - 17- 006 - Updated Version of the Technical Specifications for Reports sent via MCEDT. The purpose of the OHIP Technical Bulletin is to provide vendors and physicians with information regarding file layouts to determine if changes to their systems are needed to recognize, download and read these reports via MCEDT. The Bulletin contains the following information for vendors and physicians:

  • Adobe Portable Document Format (.pdf).
    • This report will appear the same as it existed on paper.

  • Tab Delimited File
    • The Tab delimited file is broken up into 7 columns, represented by:
    • Column 1: Category
    • Column 2: Type of Claim
    • Column 3: Billing Clinic
    • Column 4: Roster Phys #
    • Column 5: Patient HN
    • Column 6: Fee Code
    • Column 7: Amount Paid

  • The naming convention for this report will follow existing reports for MCEDT.
    • DCT – Detail Categorization of Claims Report TAB
    • DCP – Detail Categorization of Claims Report PDF

  • Example - DCP-123456-0BAAA-24Jul2017.pdf
    • DCP = Report Type
    • 123456 = Provider Number
    • 0BAAA = Group Number
    • 24Jul2017 = Delivery Date
    • .pdf = File Extension

  • The report is delivered to individual providers that are part of eligible Primary Care Models;
    • Family Health Network (FHN)
    • Family Health Organization (FHO)
    • Group Health Centre (GHC)

The technical specification document is posted on the Ministry of Health and Long-Term Care website.

For any inquiries regarding the changes to consent reporting please contact the Service Support Contact Centre:

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.

For More Information

Call ServiceOntario, Infoline at:
1-866-532-3161 (Toll-free)
In Toronto, (416) 314-5518
TTY 1-800-387-5559.
In Toronto, TTY 416-327-4282
Hours of operation: Monday to Friday, 8:30am - 5:00pm