Ontario Health Insurance Plan

Resources for Physicians

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.

 

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.

Physician Registration


Register for an OHIP Billing Number

You must register with the Ministry of Health (the ministry) in order to receive an Ontario Health Insurance Plan (OHIP) billing number to submit claims for insured services.

In order to register for an OHIP billing number, the ministry requires that you hold a valid certificate with the College of Physicians and Surgeons of Ontario (CPSO) and you must have an Ontario practice address.

For further information on how to register for an OHIP billing number, please refer to the ministry’s webpage on OHIP Billing Number Registration.

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Mandatory Practice Address Reporting

All physicians are required under Regulation 57/97 to the Health Insurance Act to provide in writing to the ministry, an address for every place they regularly provide insured services in Ontario to insured persons. If a physician plans to change the place where they regularly provide insured services, they must give the ministry the address of the new place 30 days before the change occurs.

Where multiple addresses exist, the physician should identify which address is the primary practice site where possible. In addition to each address, physicians must indicate whether services are provided as a locum tenens and/or provided as delegated procedures carried out under direct supervision of the physician.

Provisions governing delegated procedures can be found in the General Preamble section of the Schedule of Benefits for Physician Services.

Practice addresses are not considered personal information and may be disclosed upon request pursuant to the Freedom of Information and Protection of Privacy Act and as such, it is recommended that your residential address not be provided.

The ministry may require supporting documentation to validate your address information and may request information on any other practice addresses. In addition, you may be contacted to verify and/or update your address data currently on file with the ministry.

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Process to Register for an OHIP Billing Number

How do I get an OHIP billing number?

You must complete the “Application for OHIP Billing Number for Health Care Professionalsform (3384-83) and return to the ministry for processing. Please submit by one of the following methods:

  • scanning original and sending by email
  • Faxing original to (613)-545-5848
  • Mailing original to:

Ministry of Health
Claims Services Branch
Provider Registry Unit
PO Box 68
Kingston, ON K7L 5K1

When the application form is approved and processed, you will receive a letter from the ministry mailed to the practice address provided on the application with your assigned OHIP billing number and the effective date.

Who can I contact if I have questions?

Call the Service Support Contact Centre (SSCC) - 1-800 262-6524

Hours of operation: 8:00am - 5:00pm

What kind of certificate is required from the CPSO in order to bill the ministry?

In order to bill the ministry you must hold one of the following valid types of certificate from the CPSO:

  • Independent Practice
  • Academic Practice
  • Supervised Practice of Short Duration
  • Restricted Practice

In order to obtain an OHIP billing number, the ministry requires that hold a valid certificate with the CPSO. If you hold an educational licence, you are not eligible to apply for an OHIP billing number.

I’ve graduated, have my independent practice certificate and am working now. Can I work while waiting for my billing number to be issued and bill retroactively?

When you have been assigned a billing number, you may bill retroactively up to six months prior to receiving your billing number but no earlier than the effective date of your certificate.

Now that I have my billing number how do I go about submitting claims?

Your claims must be submitted by electronic data transfer in accordance with Section 38.3 of Regulation 552, to the Health Insurance Act.

Refer to Claims Submission for information on how to submit your claims.

If I work as a locum may I use the employing physician billing number?

No, you must submit claims using your own billing number. However, refer to the "Delegated Procedure" section of the General Preamble of the Schedule of Benefits for Physician Services for rules regarding submitting claims for delegated procedures in a locum tenens.

Who do I report my address change to?

You must complete the “Change of Address for Health Care Professionalsform (4885-84):and return to the ministry for processing to:

Ministry of Health
Claims Services Branch
Provider Registry Unit
PO Box 68
Kingston, ON K7L 5K1

by email: ProviderRegistration.MOH@ontario.ca

Fax to (613)-545-5848

The ministry will need at least 30 days advance notice of the change.

Where can I find OHIP forms?

OHIP forms are available online.

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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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