ClinicAid OHIP billing software makes it simple and safe to send and retrieve claims with your own GoSecure account, so you control a secure and automated means of claim filing.
You're in good company with the hundreds of other Ontario Physicians who trust ClinicAid
How ClinicAid helps MDs billing in Ontario
Formedical billing software, Ontario practices are turning to ClinicAid OHIP billing software to save time and money. ClinicAid does this by automating processes such as batch edit reconciliation, so you only enter changes or corrections once across the same field in different claims within a batch.
You’re informed of these changes by our error reports and automated remittance advice that provides claims insights and potential error identification before you submit. That means fewer claim rejections and faster payments for the full amount that you have coming to you.
ClinicAid provides service code and DX code search fields, so it’s a simple process to search to find the right billing codes electronically. You’ll always have access to the current updated OHIP fee schedules to ensure there are no errors or loss of time searching for the right code. You can’t afford the time expenditure or the error risk of fully manual data entry and code searches. Running your practice and providing the best treatment for your patients is always the priority, and ClinicAid OHIP billing software makes that possible.
With ClinicAid medical billing software, Ontario practices have access to instant service code and DX code search fields. That enables you to quickly identify and input the right code for the right procedure and patient every time. You’re always assured that ClinicAid delivers access to the most up to date and accurate codes, rules, and claims process automation to support clean and accurate claims submissions and fast reimbursement.
The added referral provider OHIP billing number search fields makes it faster and easier to relay referral physician info on an electronic claim submission form.
Submitting claims to OHIP
Medical professionals in Ontario can submit claims to the Ontario Ministry of Health and Long-Term Care (MOHLTC) for medical services provided to patients that are insured through the Ontario Health Insurance Plan (OHIP). Being able to send claims in electronically allows care providers to receive assessment on their claims and get paid for the services provided quickly. The MOHLTC uses the Medical Claims Electronic Data Transfer (MC EDT) system to allow physicians and other medical professionals to directly connect and share data with the Ministry.
What is MC EDT?
MC EDT is a service that allows secure electronic transfer of files between an authorized user and the MOHLTC. Users that have gone through the authorization process with the Ministry of Health are able to either connect directly through the web user interface (a web page), or can use a billing software, such as ClinicAid, or EMR system that connects through the MC EDT web service.
Files that contain claims can be uploaded and remittance advice (RA) files can be downloaded through the MC EDT system, allowing care providers to complete their billing easily online.
Who can use MC EDT?
Physicians, medical office staff, and other care providers, that have gone through the authorization process are able to submit their medical billing through MC EDT. Medical professionals also have the option of designating someone (a billing agent, staff member, or a billing software) to submit claim files on their behalf.
The authorization process consists of getting a GO Secure ID and password that allows care providers to access the MC EDT service with their unique account credentials. Once the GO Secure details are received, physicians will be able to connect directly to submit claims through MC EDT.
Medical billing claims submitted through MC EDT
Once connected to MC EDT, care providers can begin submitting claims for services they’ve provided to patients. Claims are generally sent in batch files and receive an initial response file back from the system within 24-48 hours of submitting. This initial response file will identify basic errors in claims, such as incorrect version codes on patient health cards, invalid personal health numbers (PHNs), and other easily noticeable errors.
Within a couple of weeks of the cut-off date, a full remittance advice list with assessment for most or all of the claims submitted should be received.
How Ontario's medical billing cycle works
The Ontario medical billing cycle completes on a monthly basis. It follows a general pattern which may be slightly modified based on holidays and other factors. The usual cycle is as follows:
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- the 18th of each month: official cut-off is on the 18th of every month* at 5:00 p.m. EST. This is a soft cut-off which means that any claims received in the following few days will often still be accepted and processed for assessment, if time and volume permits. Otherwise, they will be assessed during the next billing cycle.
- the beginning of each month, generally by the 7th: the official remittance advice (RA) list is received at the beginning of each month (usually between the 5th and the 7th).
- the 15th business day of each month: claims sent in before cut-off will be assessed and paid out by the 15th business day of the following month.
Submitting medical claims in Ontario using ClinicAid
In ClinicAid, any response files and remittance advice lists received from MC EDT will automatically update the status of submitted claims and identify settled (accepted or paid in full) claims or those requiring action (rejected or underpaid).
Claims are batched in files that are sent to MC EDT every few hours. ClinicAid also performs eligibility checks in real time and is able to sent in overnight batch checks for users wishing to verify their claims before submitting them in full to MC EDT.
For more instructions on how to get set up with billing in Ontario, please read our Getting Started guide.
Getting Set-up with MC EDT for OHIP Submissions
In Ontario, the Ministry of Health (MOH) uses a system called MC EDT (Medical Claims Electronic Data Transfer) to exchange OHIP (Ontario Health Insurance Program) claim data electronically. In order to get set-up for electronic submissions to OHIP providers must obtain a Go Secure account.
Most physicians in Ontario should have already received a letter from the MOH with instructions on how to get set up or transferred to the MC EDT system. Those who have not or are not yet set up with MC EDT should contact the OHIP Service Support Centre at 800-262-6524 or via email at SSContactCentre.MOH@ontario.ca to start the process.
What are Group Numbers used for?
If you are working with a group of care providers that are all having their payments go to a central account you would use a group number for your submissions and add that group number to your provider record.
Is eligibility checking for patients in Ontario available in ClinicAid?
Yes, ClinicAid supports electronic eligibility checking for patients in Ontario.
How often do I need to update my GoSecure password?
Your GoSecure password will expire every 120 days. Before your password expires the GoSecure system should send you an email to let you know and ask you to update your password. Once you have updated your password in GoSecure be sure to update your GoSecure credentials in ClinicAid to ensure there are no interruptions in your claim file transfers.
How do I get set-up for MC EDT / GoSecure for electronic OHIP claim submissions?
Please see details here.
