Claims Submission Ontario Health Insurance Program
Resource Manual for Physicians
 
TABLE OF CONTENTS

Section 4 - Claims Submission (Continued)

Section Contents
4.9 Province/Territory Codes . . . . . . . . . .   . . . . . . . . . . 4 - 15
4.10 Diskette Label Information . . . . . . . . . .   . . . . . . . . . . 4 - 16
4.11 Rejection Conditions . . . . . . . . . .   . . . . . . . . . . 4 - 17
4.12 Error Codes . . . . . . . . . .   . . . . . . . . . . 4 - 24
4.13 Explanatory Codes . . . . . . . . . .   . . . . . . . . . . 4 - 29
4.14 Specialty Codes . . . . . . . . . .   . . . . . . . . . . 4 - 38
4.15 Diagnostic Codes . . . . . . . . . .   . . . . . . . . . . 4 - 40
4.16 Questions and Answers . . . . . . . . . .   . . . . . . . . . . 4 - 102

Section 5 - Registration for Ontario Health Coverage

Section Contents
5.1 Client Registration Overview . . . . . . . . . .   . . . . . . . . . . 5 - 2
5.2 Eligibility Overview . . . . . . . . . .   . . . . . . . . . . 5 - 3
5.3 Health Cards . . . . . . . . . .   . . . . . . . . . . 5 - 4
5.4 Health Card Validation . . . . . . . . . .   . . . . . . . . . . 5 - 8
5.5 Health Number Release . . . . . . . . . .   . . . . . . . . . . 5 - 11
5.6 Questions and Answers . . . . . . . . . .   . . . . . . . . . . 5 - 12

Section 6 - General Information

Section Contents
6.1 Acts (Legislation) . . . . . . . . . .   . . . . . . . . . . 6 - 2
6.2 Local Health Integration Networks . . . . . . . . . .   . . . . . . . . . . 6 - 4
6.3 Emergency Health Services . . . . . . . . . .   . . . . . . . . . . 6 - 4
6.4 Assistive Devices Program . . . . . . . . . .   . . . . . . . . . . 6 - 5
6.5 Community Care Access Centres . . . . . . . . . .   . . . . . . . . . . 6 - 5
6.6 Cancer Care Ontario . . . . . . . . . .   . . . . . . . . . . 6 - 5
6.7 Ontario Drug Benefit Programs . . . . . . . . . .   . . . . . . . . . . 6 - 6
6.8 Family Health Teams . . . . . . . . . .   . . . . . . . . . . 6 - 6
6.9 Underservices Area Program . . . . . . . . . .   . . . . . . . . . . 6 - 7
6.10 Academic Health Science Centre/Alternate Funding Plan . . . . . . . . . .   . . . . . . . . . . 6 - 7
6.11 Homes for Special Care . . . . . . . . . .   . . . . . . . . . . 6 - 8

Ontario Ministry of Health and Long-Term Care
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