In the CHR, you use Insured Billing to create provincial (OHIP) bills. You create OHIP bills in the CHR and then submit them to MDBilling. From MDBilling you submit the bills to the MOH.
Before you can bill OHIP, you must have a MDBilling account set up. See Integrating your CHR account with MDBilling.
You can create insured bills from the following locations:
an encounter (for providers who want to bill during or after each patient visit)
the patient's chart (for staff or providers who want to bill services without a visit or encounter)
the billing dashboard via Quick Billing
Each bill has these fields:
Field | Description |
Status
| Before a bill is saved, there are two statuses:
If there are any configured payment tags, these appear at the bottom of the list of statuses.
Once a bill is saved, additional statuses are available. See CHR Billing Statuses for more information.
💡 Tip: You can set the default status for new bills. See Setting your default billing status for more information.
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Location | If you have more than one clinic location, and location is set to Default:
To change the location, click the field, and select one from the list. |
Payment Issuer (if you're billing from the Visits dashboard or from the patient's chart) Template (if you're billing from an encounter) | Ensure Ontario Health Insurance Plan is selected for OHIP bills.
To make OHIP your default billing item template, see Configuring account insured billing defaults and settings. |
Patient/Identification (This field is available only if you're billing from the Visits dashboard or from the patient's chart.) | The patient's information is auto-populated based on the chart or appointment you created the bill from.
The patient's health card validation (HCV) status is displayed:
💡 Tip: to update the patient's demographic information on the bill, click the patient's name. 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. |
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. ⚠️ Important: The billing practitioner must be connected to MDBilling in order to submit bills. |
Service Date (if you're billing from the Visits dashboard or from the patient's chart) Visit Date (if you're billing from an encounter) | If you created the bill from the patient chart:
If you created the bill from an encounter:
If you created the bill from the Visits dashboard:
💡 Tip: 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. |
MOH Group | If all providers bill under one group, the MOH group number is displayed.
If there is more than one group or a combination of solo and group, this field is blank.
Click MOH Group to enter or change the group number for this bill. |
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.
⚠️ Important: If you are a specialist, this field is required by the MOH for you to receive payment. |
Service Location | If you are required to submit Service Location Indicator (SLI) codes, select an SLI code from the list.
💡 Tip: If you have a default service location configured in your MDBilling integration in the CHR, it populates automatically on the bill.
⚠️ 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.
Valid SLI codes are:
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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.
📌 Note: Any supporting documentation for the claim should be faxed to the MOH. |
Admission Date | If you are creating an inpatient bill, click Admission Date and enter the date you admitted the patient. |
Manual Review | You can flag a bill for manual review. By default the Manual Review field is unchecked, to flag the item for manual review click the field.
This is useful for fee codes, such as K035, when a provider wants manual adjudication.
📌Note: Any supporting documentation for the claim should be faxed. |
Facility | If you are creating an inpatient or outpatient bill, click Facility > Select One..., and search for the institution by name or facility number.
💡 Tips:
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Updated September 23, 2024