Learn More >

Ministry Status: Routine Monitoring and Engagement

Ontario Health Insurance Plan

OHIP Bulletins


INFOBulletin

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

To: All Health Care Providers

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

Date Issued: March 22, 2019

Bulletin Number: 2139

Re: Updated Remittance Advice Inquiry (RAI) Process

Posted Electronically Only

PDF Version


Effective April 1, 2019, the Ministry of Health and Long-Term Care, Claims Services Branch (CSB) will no longer be returning Remittance Advice Inquiry (RAI) forms where adjustments have been completed as requested. Providers should review and reconcile their Remittance Advice (RA) each month for completed adjustments.

Remittance Advice Inquiry (RAI) forms will only be returned if a request has been partially adjusted, denied or if further information is required. The returned Remittance Advice Inquiry form will be returned with an explanation to the provider or billing agent. For providers submitting claims via Medical Claims Electronic Data Transfer (MCEDT), the form will be returned electronically. For those providers who submit paper claims, the forms will continue to be returned via mail.

Bulk Adjustments

The ministry is reminding providers that since September 1, 2018, all bulk adjustments should be submitted to casbulkadjustments@ontario.ca. A bulk adjustment is defined as Remittance Advice Inquiries (RAIs) relating to the same issue, for the same physician, on more than twenty (20+) claims.

Please be advised that there is no change to the processing of these bulk adjustments, just to the location of submission. Remittance Advice Inquiries that do not fall under the bulk adjustment category will remain status quo.

eSubmit

Reminder to submit Remittance Advice Inquiries and supporting documentation through eSubmit, the secure, online portal. eSubmit allows submission of Remittance Advice Inquiries and supporting documentation electronically with a receipt confirming the submission was received by the ministry. Requests for additional information as well as responses to Remittance Advice Inquiries are sent directly to your Medical Claims Electronic Data Transfer (MCEDT) account.

For inquiries related to this change, or to register for eSubmit, please contact the Service Support Contact Centre by phone at
1-800-262-6524.

You may also visit the ministry website for additional information.

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

 
  • Connect With Us
Facebook Twitter YouTube RSS