Ontario Health Insurance Plan
Education and Prevention Committee (EPC) Billing Briefs are prepared jointly by the Ministry of Health (MOH) and the Ontario Medical Association (OMA) to provide general advice and guidance to physicians on billing matters.
Billing for OHIP Services – Resources for Physicians
Category: All Ontario Physicians
Date of publication: November 3, 2022
Claims Tips: The Ministry of Health and the Ontario Medical Association provide a variety of resources to assist physicians in the appropriate submission of fee-for-service claims.
Education and Prevention Committee
The Ministry of Health (MOH) and the Ontario Medical Association (OMA) have jointly established the Education and Prevention Committee (EPC). Since 2003, the Education and Prevention Committee has developed education for physicians about submitting OHIP claims for payment for the insured service provided.
OHIP Resources for Physicians webpage
The Resources for Physicians webpage includes information about OHIP billing policies and procedures (such as applying for a billing number), educational modules to help physicians understand the Schedule of Benefits for Physician Services as well as specific fee codes listed in the Schedule. This webpage provides links to additional references including INFOBulletins and now, EPC Billing Briefs.
EPC Billing Briefs
The newly launched EPC Billing Briefs focus on specific billing issues. Each brief will identify the areas of practice it covers and may provide relevant clinical examples to illustrate key points. Notice of new EPC Billing Briefs will be included in OHIP Announcements.
Your feedback is welcome and appreciated. To provide feedback on EPC Billing Briefs, or to suggest topics for future EPC Billing Briefs, send an email to the attention of the joint Ministry of Health and OMA Education and Prevention Committee.
Claims Contact Information
For additional information on billing, please visit the Resources for Physicians and the How to Get Help with Billing Questions pages on the ministry website.
If you have any billing or claims submission inquiries, please contact the Service Support Contact Centre (SSCC) by email or by calling 1-800-262-6524.
INFOBulletins
INFOBulletins are communications from the Ministry of Health. The communications inform of payment, policy, program or software changes.
Sign up to get INFOBulletins directly by email.
OHIP Announcements
OHIP Announcements are updates from the Ministry of Health which communicate OHIP related non-technical communications (example: system outages) in addition to new educational resources from EPC.
Sign up to get OHIP Announcements directly by email, available in English and French.
Ontario Medical Association Resources
The Ontario Medical Association provides additional educational resources to its members, including an accredited CPD module, Introduction to OHIP Billing, developed by the Education and Prevention Committee.
When additional help is required
For additional information, please visit the Ministry of Health and Ontario Medical Association jointly created How to Get Help with Billing Questions resource on the ministry website.
Contact the Ministry of Health Service Support Contact Centre
- By email or by calling 1-800-262-6524 (Monday-Friday; 8:00 a.m.-5:00 p.m.).
- Ministry staff are available to respond to calls from physicians requiring billing assistance that is not addressed by the resources listed above.
Contact the Ontario Medical Association
- OMA staff can provide guidance on routine billing questions, claims reconciliation processes and other questions, and may liaise with the ministry to obtain further information on behalf of physicians.
- Contact info@oma.org for individualized assistance.
Keywords/Tags
Education and Prevention Committee; EPC; OHIP Claims; OHIP Payment
The Ministry of Health (MOH) and the Ontario Medical Association (OMA) have jointly prepared this educational resource to provide general advice and guidance to physicians on specific billing matters.
The Ministry of Health (MOH) and the Ontario Medical Association (OMA) have jointly established the Education and Prevention Committee (EPC). The EPC’s primary goal is to educate physicians about submitting OHIP claims for payment for the insured service provided.
EPC Billing Briefs are prepared jointly by the MOH and the OMA to provide general advice and guidance to physicians on billing matters. EPC Billing Briefs are provided for education and information purposes only. The information provided in this EPC Billing Brief is based on the October 2021 Schedule of Benefits - Physician Services (Schedule).
While the OMA and MOH make every effort to ensure that this EPC Billing Brief is accurate, the Health Insurance Act (HIA) and its Regulations prevail over anything stated in this EPC Billing Brief. Changes in applicable statutes, regulations, or case law may affect the accuracy or currency of the information provided in this EPC Billing Brief. In the event of a discrepancy between this EPC Billing Brief and the HIA or its Regulations and/or Schedule under the regulations, the text of the HIA, Regulations and/or Schedule prevail.
Note: This document is technical in nature and is available in English only due to its limited targeted audience. This publication has been exempted from translation under the French Language Services Act. For questions or support regarding this document, please contact the Service Support Contact Centre (SSCC) by email or by calling 1-800-262-6524.
Remarque : Ce document est de nature technique et est disponible en anglais uniquement en raison de son public cible limité. Ce document a été exempté de la traduction en vertu de la Loi sur les services en français. Pour toute question ou de l’aide concernant ce document, veuillez contacter Les Services de renseignements, Centre de contact pour le soutien des services par courriel ou en téléphonant le 1-800-262-6524.
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