The Ontario billing (MDBilling) workflow consists of two main steps:
Creating bills in your CHR account to be sent to MDBilling
Submission, reconciliation, and reporting of all bills from MDBilling to the Ministry of Health (MOH)
Ensure you have created and integrated your MDBilling account by contacting your CHR Team. See MDBilling Integration.
1. Creating insured billing items within the CHR
There are four ways to create an insured (OHIP) bill within the CHR
Create the bill in an Encounter. See Creating insured billing items from an Encounter
Create a bill within the Visits Dashboard. See Creating insured billing items from the Visits dashboard.
Creating a bill from the Insured Billing Section of the patient's chart (not recommended)
Using an encounter template with default billing items. See Adding Billing Items to Encounter Templates
💡 Tip: This is the most efficient way when the client is billing with a select few billing codes.
2. Reviewing Bills
To review bills in your CHR account, you can:
Refer to the billing dashboard to see all bills that are associated with a signed encounter, OR
Refer to the visits dashboard to see all day to day bills that are associated with an appointment.
3. Sending bills to MDBilling
Draft: A status of draft means once your bill has been created, you will need to manually change the status to Ready To Submit.
Ready: A status of ready means once your bill has been created and associated with a signed encounter it will automatically submitted to MDBilling without intervention on your end.
Your CHR account's default billing status can be customized to Draft or Ready. See Public Billing Settings.
📌 Note: If a bill is set to a status of DRAFT, it can still be modified within the CHR.
Once a bill has been submitted they will queue in MDBilling’s dashboard under SAVED.
4. Submitting claims to the Ministry of Health (MOH)
Once your bills have been sent from the CHR to MDBilling, you will find all bills are queued in your Saved Claims folder in MDBilling.
📌 Note: Once a claim is submitted, you cannot make any changes until reconciliation returns from the Ministry.
⚠️ Important: The billing cycle requires that claims are submitted by the 18th of every month.
5. Reconcile and resubmit claims to the Ministry of Health (MOH)
MDBilling processes the claims typically within the first few days of the following month.
The CHR user has to log back into MDBilling to reconcile and resubmit any rejected claims. See Re-submitting rejected claims.
💡 Tip: You can setup permissions in your MDBilling account to allow another staff member to log in and manage your billing.