Once you have submitted your claims from the MDBilling portal to the Ministry of Health (MOH), the Ministry validates your bills before they process the claims and make payment.
If any of your bills are rejected the MOH provides a Claims Error report (48 hours after submitting claims via MDBilling), so you can correct errors and resubmit the bills for payment.
💡 Tip: The MOH provides explanations of the most common Claims Error codes on their website.
📌 Note: When a bill is included in a Claims Error report, the MOH server deletes that bill from its database. In essence, the MOH has rejected the bill. For this reason, if you contact the EDT help desk or your MOH resource about a bill that was on a Claims Error report, you may be told that the bill was never received. This is because the server deleted the bill from the database. This is also why bills that are included on a Claims Error report will never show up on a remittance advice report.
From the main menu, click Billing.
To see all refused (rejected) claims, filter the Billing dashboard by:
Status: Attention Required
Insurer: Ontario Health Insurance Plan
Applicable Service Date
A billing report appears.
📌 Note: The billing report includes Attention Required: Invalid bills which are not part of the Claims Error report. See Ontario billing statuses for more details.
Find Attention Required: Refused claims by searching for bills that have $0.00 payment under the Amount column.
Click the bill.
The Edit Insured Payment window appears.
Read the Messages, e.g. updating the patient's version code, and fix the error by clicking on the specific area of the bill and modifying it.
Once fixed, at the top of the bill next to Status select Ready to Submit.
The bill is resubmitted to MDBilling and a new claim is created in MDBilling. This will be included the next time claims are submitted to the MOH.
Since the fixed bill is a new claim in MDBilling, you must archive the original rejected claim in the MDBilling portal.
a. To search for specific rejected claims in MDBilling, click Lookup Claims.
b. From the Lookup Claims page, click the Patient field, type the first two letters of the patient name and select the correct patient name with health card number.
c. Click the Status field and select Rejected.
d. Click Search.
A list of claims with Status: Rejected appears.
e. Find the claim you want to archive and click Action > Archive.
💡 Tip: We recommend you take the time to correct the errors from the Claims Error report as soon as possible so that you can re-bill with corrections in time for the cut-off and still get paid.
Updated April 25, 2022