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Ministry Status: Activation Status

Ontario Health Insurance Plan

OHIP Bulletins

OHIP Technical Bulletin

Ensuring excellence in claims service delivery for Ontarians

To:  OHIP Billing Software Vendors

Published by:   Claims Services Branch

Date Issued:  January 19, 2017

Bulletin Number:  17-002

Re:  Electronic Submission of Supporting Documentation and Remittance Advice Inquiries

Posted Electronically Only

PDF Version Portable Document Format | 232 Kb

Claims Services Branch is pleased to announce that eSubmit, a new, secure electronic channel for submitting documents containing personal health information to the ministry, is now available.

Starting February 1, 2017, the first phase of eSubmit will allow health care providers to electronically submit a remittance advice inquiry or supporting documentation, such as operative reports, consult report/notes, etc. required to adjudicate complex claims.

Refer to INFOBulletin #4688 – Electronic Submission of Supporting Documentation and Remittance Advice Inquiries, for further information on the eSubmit service.

At this time eSubmit cannot be used to submit documentation automatically using software such as Electronic Medical Record (EMR). Health care providers that submit large volumes of supporting documentation or remittance advice inquiries may find that this phase of eSubmit may not align with their current business processes. The ministry will be reaching out to high volume submitters as well as software vendors to discuss options for using eSubmit.

If you have any questions please contact the Service Support Contact Centre at 1-800-262-6524 or SSContactCentre.MOH@ontario.ca

Remittance advice inquiry responses and requests for additional information contain personal health information and cannot be sent via email. They will be sent using the secure MCEDT generic communications function and can be accessed from the MCEDT download screen. They will have a file type of GCM and a subject of General Communications.

They will be posted with the following file name standard:

Remittance Advice Inquiry Response RAIxxxxxxxxx_xxxxxx.pdf
Additional Information Request ADDxxxxxxxx_xxxxxx.pdf

The numbers after the first three characters will be the provider billing number (group number if a group and solo number if a solo) followed by the ticket number.

Downloading of these documents from MCEDT can be automated using EMR software. If your software does not download GCM files, you may want to discuss this with your clients.

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

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