Bulletin 211001 — Methodology to Implement One-Time Payments to Optometrists
Methodology to Implement One-Time Payments to Optometrists
OHIP Optometrists to receive $39 million in one-time payments for OHIP services rendered on or after April 1, 2011 and before April 1, 2021
Category: Optometrist Services
Written by: Claims Services Branch, Ministry of Health
Date Issued: October 4, 2021
The Ministry of Health (ministry) is implementing a one-time payment to eligible optometrists in accordance with the Methodology for the Implementation of the 2021 OHIP Optometry One-Time Payments set out in Appendix A.
The ministry anticipates issuing the one-time payments in October 2021 for individual optometrists.
Optometrists who receive a Remittance Advice (RA) report will see the payment reported under the accounting transaction “2021 OHIP Optometry One-Time Payment”.
These retroactive payments will be made to the individual optometrists’ bank account or by cheque when banking information has not been registered with the ministry.
For payments to be accurately processed and to avoid delays, please update your individual banking information and/or address with the ministry as necessary. Please see INFOBulletin #210903 for more on how to update your banking and address information.
Where bank account details are not available, a cheque will be issued payable to the optometrist or to the “Estate of” in the event the optometrist is deceased. Cheques will be sent to the same address on file with the ministry that was used for the RA reports.
Any questions relating to the payment or if you did not receive a payment please contact our Service Support Contact Centre by email or telephone
Ontario; OHIP; Optometrist; Optometry; One-Time Payment; Compensation
The government is doing all it can to ensure Ontarians can continue to access the high-quality insured eye health and vision care services they deserve.
Recognizing that optometrists in Ontario provide patients with critical, high-quality eye health and vision care and have not received increases to Ontario Health Insurance Plan (OHIP) compensation rates in recent years, government is providing an immediate $39 million one-time payment as follows:
Step 1: Calculating Total Payments by Individual Optometrist
The cumulative total of all OHIP approved payments for services rendered on or after April 1, 2011 and before April 1, 2021 will be calculated for each eligible optometrist.
Step 2: Calculating Individual Optometrist Payments as a Proportion of All Optometry Payments
The total payments as calculated in Step 1 will be divided by the cumulative total of all OHIP approved payments made to all optometrists for services rendered on or after April 1, 2011 and before April 1, 2021 to determine a proportionate value for each eligible optometrist.
Step 3: Calculating Individual Optometrist One-Time Payments
The proportionate value as calculated in Step 2 will be multiplied by $39 million to determine the one-time payment amount to be made to each eligible optometrist.
Additional Methodology Notes:
- All OHIP claims payment data will be extracted from the OHIP claims payment system.
- Individual optometrists will be identified based on the individual provider billing numbers used on claims submitted to OHIP.
- All out-of-province billing numbers will be excluded.
- Only calculated one-time payments of $2 or greater will be made.