Learn More >

Ministry Status: Activation Status

Ontario Health Insurance Plan

OHIP Bulletins


INFOBulletin

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

To: Optometrists

Published by: Health Services Branch, Ministry of Health

Date Issued: October 30, 2019

Bulletin Number: 8157

Re: Periodic Oculo-Visual Assessments (POVAs) for Social Assistance (SA) Recipients

Posted Electronically Only

PDF Version


This bulletin provides updated information to Bulletin 8129 issued October 29, 2014.

1. SA Recipients with a valid Health Card

Claims for POVAs provided to social assistance recipients who have a valid health card are to be submitted to OHIP in the usual manner using the appropriate fee code:

V450 Ontario Disability Support Program (includes Family Benefits Program) $39.15
V451 Ontario Works $39.15

Please note that there have not been any changes to the above process.

2. SA Recipients who do not have a valid Health Card or the claim has rejected with an EPS (Patient not eligible for program) error code

In order for payments to be processed for POVA services provided to patients who do not have a valid health card or where the claim has rejected from the claims system with the error code EPS, the optometrist must submit the following patient information to the Ministry of Health to verify that the patient is a SA recipient:

Please provide all required information listed here for SA patient related claims

  • First and Last Name of Patient
  • Patient’s Address
  • Date of Birth
  • Date of Service
  • Providers Billing Number
  • Optometrist Contact Information

In addition to the above information, any one of the following is also required:

  • Copy of the Ontario Drug Benefit Card showing month of coverage
  • Copy of the Statement of Social Assistance showing date of coverage
  • Proof of Eligibility Letter from Ministry of Children, Community and Social Services (MCCSS) Social Assistance Office
  • Eligibility confirmation report from SAV Portal (more details provided below)
  • Confirmation # from MCCSS SAV Helpline (more details provided below)

The above information can be faxed or mailed using the contact information shown below.

Claims will be processed manually, and payments will appear on your remittance advice once the identified information has been received by the Ministry of Health (MOH).

NOTE: There has been a change to the MOH mailing address.

Contract Management Unit
Health Services Branch
Ministry of Health
49 Place d’Armes, 5th Floor
PO Box 48
Kingston ON K7L 5J3
Facsimile: 613-536-3184
Inquiries: 1-866-684-8620

NOTE: There is no change to the way that eligibility for POVAs is determined. Each person is eligible for one assessment per 24 month period.

MCCSS Social Assistance Verificaton (SAV) Portal

In July 2018, MCCSS introduced a new SAV Portal for optometrists to verify a patient’s eligibility for the Ontario Disability Support Program (ODSP) including Assistance for Children with Severe Disabilities (ACSD) and Ontario Works including Temporary Care Assistance (TCA) and M’Chigeeng First Nation only.

To access the SAV Portal to verify a patient’s eligibility, you will need a unique SAV PIN that will allow you to register for an account. The SAV PIN is not the same as your IVR PIN. If you have not received a SAV PIN from MOH, please complete the Social Assistance Verification Portal PIN Request Form provided to you in previous communications from MCCSS and the Optometrist Association of Ontario. Beginning August, 2019, the form will also be available for download through the SAV Portal Home Page. Submit the completed form to provregstnmoh@ontario.ca for processing.

Once you have received your SAV PIN, please navigate to the hyperlink to Register for a SAV Portal account.

MCCSS SAV Helpline

Contacting the Social Assistance Verification (SAV) Helpline will remain available to optometrists in a diminished capacity. If you cannot access the SAV Portal or if a client does not provide alternate proof of eligibility, physicians can call the MCCSS SAV Helpline to confirm eligibility at 1-888-284-3928.


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