OHIP Publications — medical claims and health card validation

Health Care Provider resources

The reference manuals and technical specifications listed are provided to assist with creating and submitting OHIP medical claims to the ministry.

• Resources for Physicians
• OHIP Billing Number Registration
• Health Card Validation Reference Manual (PDF)
• eSubmit - submit supporting documentation and Remittance Advice Inquiries electronically
• Medical Claims Electronic Data Transfer (MCEDT)

Technical specifications

• Interface to Health Care Systems Manual (PDF)
• Electronic Business Services (PDF)
• Medical Claims Electronic Data Transfer Service via Electronic Business Services (PDF)
• Health Card Validation Service via Electronic Business Services (PDF)
• Technical Specification for Reports sent via MCEDT (PDF)
• Outside Use Report (Patients with Signed Consent) (PDF)
• eSubmit - Technical Specifications for RAI and Supporting Documentation Electronic Submissions (PDF)
• Overnight Batch Eligibility Checking (PDF)
• ICD-10 Reciprocal Billing File Technical Specifications Reference Guide for Ontario Hospitals (PDF)

Conformance testing

Specialized software is required to access the MCEDT and HCV web services. All software must be conformance tested with the ministry before gaining access to the services.

Below is a list of software vendors who have successfully completed conformance testing of their software for use with the MCEDT web service and the HCV web service. The lists are provided for information only; the ministry does not endorse or promote any specific vendor or software.

For more information

Call the Service Support Contact Centre (SSCC) at 1-800-262-6524                   
Hours of operation: 8:00 a.m. – 5:00 p.m. Monday – Friday, except holidays
E-mail: SSContactCentre.MOH@ontario.ca