⚠️ Important: You must have a MDBilling account set up to bill in the CHR. See Integrating your CHR account with MDBilling.
Creating provincial (OHIP) bills from an encounter, associated to an appointment, is the standard billing workflow for providers. See Creating provincial (OHIP) bills from encounters. However, there are unique situations when you create bills that are not attached to appointments or encounters, like submitting annual cumulative preventative care bonuses to the Ministry of Health (MOH) which are billed using a fake patient chart. You can also quickly create bills from the billing dashboard without having to first open the patient's chart. For more information, refer to Quick billing from the Billing dashboard.
Steps
1. From a patient's chart, click Start/Open > Insured Billing.
The Insured Payments window appears.
💡 Tips:
To navigate to the MDBilling.ca website, click MD Billing.
To modify insured billing settings, click the gear icon next to MD Billing. See Customizing your insured payment settings for more information.
2. Perform one of the following actions:
If you're creating a new bill, click +New Payment.
If you're reviewing or editing a bill that's already been created (for example, if the provider created the bill from the encounter), click the bill.
The New Insured Payment window appears.
3. Complete or change the following bill fields, as necessary. For more information, see Creating provincial bills.
💡 Tip: You can use billing templates to speed up your billing process, in the top-right corner, click Template. For more information, refer to Using billing templates.
a) Status: defaults to your selected default billing item status (Draft or Ready to Submit). If you have any payment tags configured (see Creating payment tags), you can also select one or more from the bottom of the list.
b) Location: if you have more than one location, select the location where the patient was seen from the list.
c) Payment Issuer: Ensure Ontario Health Insurance Plan is selected.
d) Patient/Identification: The patient's information is auto-populated based on the chart you created the bill from. If this is not the correct patient, cancel the bill and open the correct patient's chart.
💡 Tip: You can easily see the patient's health card validation (HCV) status. A green box appears next to a valid health card number and a red box appears next to an invalid health card number. To update the patient's demographic information on the bill, click the patient's name. However, this does not update the information in the patient's chart. To change the patient's demographic information on the chart (which will then apply to the bill), click the person icon.
e) Billing Practitioner: If you are a provider, by default your name is displayed. If you are not a provider, you must select a billing practitioner. Click No Provider Selected, and then click No Provider Selected again in the window that appears. Search for the appropriate provider. Under Available Billing Provider, select MD Billing.
⚠️ Important: The billing practitioner must be connected to MDBilling in order to submit bills. Do not create any bills within the CHR until your contact at TELUS Health informs you that the MDBilling integration is complete.
f) Service Date: If you are logged in as a billing provider and the patient had a recent (past) appointment booked in your schedule, the date defaults to the appointment date. Otherwise, the service date defaults to today's date. Click the date to select a different one from the calendar, or to select a date from a list of the patient's Latest Appointments.
g) MOH Group: To change the group number for this bill, click MOH Group and select a different one from the list.
h) Referring Physician Billing Number: If there is a Referring Practitioner specified in the patient's demographics, their billing number appears here. If there is no referring provider specified and the bill requires one, either type the referring provider's billing number or click the magnifying glass icon to search for the provider in your list of contacts.
i) Service Location: If you are required to submit SLI codes, select an SLI code from the list.
⚠️ Important: If you are using SLI codes, you must enable a setting in your MDBilling portal. See Enabling Service Location Indicator codes for more information.
j) WSIB: If the bill is to be paid by the MOH but is WSIB-related (such as minor assessment because of work injury), click WSIB and select Yes.
k) Admission Date: If you are creating an inpatient bill, click and enter the date you admitted the patient.
l) Manual Review: Click to flag a bill for manual review. This is helpful for fee codes, such as K035, when a provider wants manual adjudication.
m) Facility: If you are creating an inpatient or outpatient bill, click and search for the institution by name or facility number.
n) Specialty: If you want to change the default specialty, click and search for the specialty by name or code.
💡 Tip: To set a specialty as a favourite, select the star icon beside it. When you create a bill, starred favourites appear first in the Specialty search list.
4. To add a service code (billing item) to the bill, click + Add Fee Item and, in the Edit Ontario Billing Item window, complete the applicable fields. See Adding and modifying billing items (service codes) for your provincial bills (ON).
💡 Tip: You can quickly bill previously billed service codes for the patient by clicking the clock icon to the right of +Add Fee Item. For more information, refer to Duplicating a fee item on a bill.
5. To save the billing item, click outside the Edit Billing Item window. The service code is added to the bill.
6. To add additional service codes, click +Add Fee Item.
7. To edit or delete a billing item, click it.
8. To add internal only notes associated to the bill, under Internal Notes, click in the empty box and type. These notes are not included in the submitted claim.
10. Click Save. Depending on your settings, the claim status either remains as Draft or it changes from Ready to Submit to Submitted or Attention Required. See CHR Billing statuses for more details.
Updated January 24, 2025