Bulletin 230704 — Reminder: Health card validation
Patient health cards should be validated at every visit
To: All Physicians, Hospitals, Community Laboratories, Community Surgical and Diagnostic Centres (Independent Health Facilities), Optometrists, Hospital-based Dentists, Podiatrists
Category: Physician Services, Primary Health Care Services, Independent Health Facilities, Optometrist Services, Dentist Services, Podiatrist Services
Written by: Claims Services Branch, Health Programs and Delivery Division
Date issued: July 14, 2023
Bulletin Number: 230704
Reminder: validate health cards at every visit
The Ministry of Health’s Health Card Validation service helps health care providers and other clients determine patient eligibility and the validity of an Ontario health card.
Providers should ask for an individual’s most recent health card and validate it each time the patient visits. Validation will help reduce the number of claims that are rejected including for patient ineligibility.
Health cards that pass validation should be accepted and standard OHIP billing procedures should be followed. A card that passes validation would receive a response code between 50-55 from the ministry’s Health Card Validation system.
If a health card does not pass validation, health care providers should take the following steps:
- check for keying errors
- confirm the health number and version code
- ask if the cardholder has another health card
- ask the cardholder to contact ServiceOntario to update their health card registration
If a claim was previously rejected due to an invalid version code or health card eligibility issue, the provider can resubmit the claim once the patient presents with a new valid health card and version code.
Further information regarding Health Card Validation can be found in the Health Card Validation Reference Manual.
health card; OHIP card; health card validation; HCV; eligibility