Ohip Bulletin and Govenment logo
Bulletin Number

8088

Date

December 18, 2002

Direct inquiries to

Ministry of Health and Long-Term Care Processing Office

(See Address Below)
Distribution

Optometrists


Subject

Claims Submission Protocol

The ministry continues to investigate ways to improve the processing of claims for insured services and at the same time promote the ministry’s e-government plan for streamlining its business processes through technology.

Paper Claims Processing Fees

A processing fee of $0.50 ($0.47 + $0.03 GST) has been levied for OHIP claims submitted on paper claim cards since July 10, 1993. The volume of claims submitted on paper has been steadily declining over the last few years. However, the cost of processing these claims has continued to increase.

The fee charged for processing claims submitted on paper claim cards on or after January 01, 2003 will increase to $2.00 ($1.87 + $0.13 GST) per claim. The processing fee will apply to all paper claims submitted to the ministry, with the following exceptions :

  • Reciprocal Medical Billing (RMB) claims,
  • Workplace Safety & Insurance Board (WSIB) claims,
  • Outaouais Regional Health Council claims,
  • Ministry of the Attorney General claims (service codes K018, K021, K061),
  • Ministry of the Solicitor General claims (service codes K018, K021),
  • Ministry of Community, Family and Children’s Services claims (service codes K050, K051, K052, K053, K054, K055),
  • Claims submitted for service encounter data collection, and
  • Claims submitted by out of province providers registered with the ministry.

Claims submitted via Electronic Data Transfer (EDT), 3½ inch diskettes and magnetic tape or cartridges remain exempt from any processing fee.