Resources for Physicians
Find learning materials that will help physicians bill OHIP.
This information requires knowledgeable interpretation. It is intended primarily for members of the professional health care community.
Physicians are responsible for understanding and complying with payment requirements for any and all claims submitted to OHIP using their billing number.
OHIP registration and billing number maintenance
- OHIP billing number registration
- Physician registration
- Getting ready to practice in Ontario
- Applying for an OHIP billing number
- Welcome package and GO Secure registration
- Designation instructions
Payment and Schedule of Benefits
- How to get help with billing questions (PDF)
- Understanding the Schedule of Benefits for Physician Services (PDF)
- Physician payment
- Schedule of Benefits
- OHIP INFOBulletins
Guidance on specific billing matters
- Education and Prevention Committee Billing Briefs
- Assessments and consultation (PDF)
- Requirements for time-based services (PDF)
- Special visits premiums (PDF)
- Physician fee-for-service post-payment audit process (PDF)
- Summary of physician fee-for-service post-payment audit process (PDF)
Electronic business services
- Medical Claims Electronic Data Transfer
- eSubmit for supporting documents, Remittance Advice Inquiries and additional information requests
- Welcome to eSubmit
- Health Card Validation Reference Manual
Submission of claims
Patient eligibility and health cards
Note: Claims for payment submitted to the Ontario Health Insurance Plan (OHIP) must comply with the legislative requirements of the Health Insurance Act and its regulations, including the Schedule of Benefits for Physician Services. The ministry ensures compliance with these requirements to claims for payment on behalf of the General Manager of OHIP.
To ensure prompt payment, submitted claims are paid on an honour system after being processed through computerized checks. These initial checks and resulting payment do not mean that all requirements have been met.
The ministry may review paid claims. Should the ministry determine that claims were paid that did not meet requirements (such as: a circumstance in section 18 (6) of the Health Insurance Act exists), the ministry may seek reimbursement by requesting a hearing of the Health Services Appeal and Review Board (HSARB) to review the payments.