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.
1. From a patient's chart, click Start/Open > Insured Billing.
The Insured Payments window appears.
2. Click +New Payment. A New Insured Payment window appears.
3. Complete or change the following bill fields, as necessary. For more information, see Creating provincial bills.
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.
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.
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: Click MOH Group to enter or change the group number for this bill, if necessary.
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.
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.
4. Add the service codes to the bill. Click + Add Fee Item. A New Ontario Billing Item window appears.
5. Complete the applicable fields:
💡 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.
The fee amount of the code you selected is automatically populated.
📌 Note: The amount can be manually changed if applicable.
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.
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. See Configuring diagnostic codes for your account.
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)
Enter the time spent with the patient in minutes.
📌 Note: This automatically updates the Finish Time.
This field is not sent to MDBilling, only the entered Start and Finish time.
Start Time and Finish Time
The Start Time defaults to the time you create the insured bill.
To add the time you finished seeing the patients, click the clock icon. This is important when using B (surgical assist) and C (anesthesia) billing codes for services delivered at the clinic.
📌 Note: When you create a bill and add a Start and Finish time, 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.
5. To save your changes, click outside the Edit Billing Item window when you are finished adding the service code.
6. To add additional service codes, click +Add Fee Item.
7. To edit a billing item, click it and make the required changes.
8. To delete a billing item, click it and click the trash can icon in the top-right corner.
9. 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 April 12, 2023