To submit claims for residents from other provinces (except Quebec), follow the below steps. The system sees the patient’s province code with the health card information and takes care of the submission details.
⚠️ Important: Quebec patients are excluded from the below process. The Ministry of Health (MOH) does not have reciprocal billing with Quebec. We recommend that you bill patients directly and instruct them to seek reimbursement when they return home.
Steps
1. Ensure that the patient's health number is recorded and has the correct identification type.
📌 Note: If you do not see the identification in the list add a new one. See Adding additional patient identifiers.
2. Create a provincial bill. See Creating provincial bills (Ontario).
📌 Note: Use OHIP billing codes when creating a bill for an out-of-province patient. Make sure the payment issuer is set to Ontario Health Insurance Plan.
The bill is submitted to MDBilling as a Reciprocal Medical Billing (RMB). Submit to the MOH as per usual.
Updated: November 3, 2021