⚠️ Important: If you work in Ontario, you must have a MDBilling account set up to bill in the CHR. See Integrating your CHR account with MDBilling.
Whether you're billing from an encounter, from the Visits dashboard or from the Insured Billing area of the patient's chart, the process for adding billing items (service codes) to a bill is the same. From the Billing dashboard, you can also open bills and modify billing items as long as the bill's status allows you to edit the bill.
Steps
1. Start a bill from an encounter, from the Visits dashboard or from the patient's chart. If you're editing a bill, open the bill from the Billing dashboard.
To create provincial bills from an encounter, click Insured Billing.
To create provincial bills from the patient's chart, click +New Payment.
To create bills from the Visits dashboard, click Add Insured Payment.
When creating bills from the patient's chart or Visits dashboard, a New Insured Payment window appears. Click + Add Fee Item.
💡 Tip: You can quickly bill previously billed service codes for the patient by clicking the clock icon next to +Add Fee Item, or for encounters click the clock icon next to Insured Billing. For more information, refer to Duplicating a fee item on a bill.
The New Ontario Billing Item window appears.
💡 Tips:
When searching for the diagnosis code, only the first 20 matches show. Exact matches show first, followed by favourites, followed by the remaining matches sorted by usage.
When searching for diagnosis by code, if the diagnosis code doesn’t exist in your default diagnosis template (Settings > Encounter > Default Diagnosis Template), any matching MDBilling diagnosis codes and descriptions are listed.
When searching for diagnosis by code, if the diagnosis code exists in both your default diagnosis template and the MDBilling diagnosis list, only matches from your default diagnosis template appear in the list.
5. Using the below table, complete the applicable fields:
Field | Description |
Code/Description |
💡 Tip: Select the star icon next to the specific code to save the code to your favourites. Every time you create a bill, the starred favourites appear first in the list. |
Base Amount
| The fee amount of the code you selected is automatically populated. 📌 Note: You can manually change the amount, if applicable. |
Quantity | If the code requires time units or number of services, such as codes for surgery, type the number of units or click the up or down arrow.
📌 Note: When you create a bill with start and finish times, the quantity is automatically set as 1. If you change the Quantity field to anything more than 1, any entered Finish Time is cleared by the system. |
Diagnosis Codes | Enter the diagnosis code, or start typing a description to search for and select a diagnosis code from the list.
💡 Tip: Select the star icon next to the specific diagnostic code to save it to your favourites. Every time you create a bill, the starred favourites appear first in the list.
📌 Note: The list of diagnosis codes available depends on what is selected as your Default Diagnosis Template in Settings > Templates. For more information, refer to Diagnosis codes. |
Service Date
| The date defaults to the service date you set earlier.
To change this date for the specific billing item, click the calendar icon. |
Time Spent (Minutes) | This field automatically populates based on the difference between the Start Time and Finish Time.
📌 Note: This field is not sent to MDBilling; only the Start Time and Finish Time are sent. |
Start Time and Finish Time | If your insured payment settings Fill start time from the linked appointment and Fill finish time from the linked appointment are enabled and your bill is linked to an appointment, the start and finish times automatically populate based on the linked appointment times. The Start Time matches the appointment's scheduled start time, while the Finish Time is calculated by adding the appointment's duration to the start time.
These settings are enabled by default. To disable them, refer to Customizing your insured payment settings.
If you started the bill from the patient's chart, the Start Time defaults to the time you create the bill.
To add or update the Finish Time, click the clock icon. This is important when using B (surgical assist) and C (anesthesia) billing codes for services delivered at the clinic. |
Override Rules | Select to override the diagnosis required rule, and any rules for the specific MDBilling fee code you are billing. For example, if you are billing an anaesthetist code that doesn’t require a diagnosis, you can submit the bill without a diagnosis for this fee code.
📌 Note: Hovering over the checkbox displays a warning message that the claim may get rejected. |
5. To save your changes, click outside the Edit Billing Item window. The service code is added to the bill.
💡 Tip: Click a billing item to edit or delete it.
6. To add additional service codes, click +Add Fee Item.
Updated January 27, 2025