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Ministry Status: Routine Monitoring and Engagement

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 24, 2018

Bulletin Number: 18-001

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

Posted Electronically Only

PDF Version Portable Document Format | 219 Kb


Commencing with the February 2018 reports, the Detailed Categorization of Claims Report will be available electronically via MCEDT. This is to further the ministry’s long- term strategy to provide reports electronically. The ministry will continue to provide paper reports for those providers who continue to receive paper Remittance Advices.

This report will be available in 2 media types;

  • Adobe Portable Document Format (.pdf)
    • Report will appear the same as it exists today.
  • 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 “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 technical specification document is posted on the Ministry of Health and Long-Term Care website in the following location:

http://health.gov.on.ca/en/pro/publications/ohip/docs/techspec_ohip.pdf

If you have any questions please contact the Service Support Contact Centre at 1-800-262-6524



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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