Submitting RAI’s
(Remittance Advice Inquiries) A remittance advice inquiry or an RAI are a form that can be found on www.ontario.ca/eSubmit. — see below for instructions This is required when a claim has rejected and appeared on a physicians remittance advice report. Required information: Health card number, claim number, date of service, fee codes (under payment, […]
Billing fees
Medical billing companies can charge up to 3% for medical claims for full service claims management. ie. $30,000 paid claims monthly Estimated Full Service Billing Fees: 1% = $300/ month 2% = $600/ month 3% = 900/ month Ontario’s medical billing fees have been a topic of debate and concern for healthcare providers and patients […]
Submitting A Manual Review
Go to www.esubmit.ca Log in to your Go Secure account Select manual review (supporting documentation) (remittance advice inquiry if it appeared on your RA) Photo above: Manual review form Must fill out: Once the form is completed, submit It will ask if you want to print the confirmation (a confirmation is emailed […]
Incorrect Service Location (SLI) – V68
BLOG # 3 – MEDICAL BILLING 101 V68 – Incorrect service location indicator – assigned when a diagnostic service isbilled with a master number and admission date but the SLI code is not HIP This rejection can be avoided a few different ways: If you have selected “HIP” and have not added a facility If […]
Differences between E082A, E083A and E084A
All 3 of these codes relate to a MRP premium (most responsible physician) E082A info found in the Schedule on page 56 (GP42) E082 – admission assessment premium *this fee code is only eligible with consults/assessments when the most responsible physician admits the patient E083A/E084A info found in the Schedule on page 61 (GP47) E083 […]
Referring Physician Rejections
Blog # 2 – Medical Billing 101 Did you know adding referring physicians on claims that don’t require it can cause unnecessary rejections??? A number of OHIP billing codes require a referring physician’s billing number to get paid. This is the case for consultations (including telephone and e-consults) & laboratory and certain diagnostic procedures. The latter include any procedure […]
Medical Billing Assistant
Assisting with medical billing in Ontario is an important role in the healthcare field. This position involves supporting healthcare professionals in the submission and processing of claims to ensure accurate reimbursement for services provided. Medical billing in Ontario is a crucial aspect of the healthcare system. It involves the submission and processing of claims for […]
Incorrect special visit premium (SVP) – ADF
Blog # 1 – Medical Billing 101 ADF rejections can appear on error reports or as DF on RA reports when a claim has ineligible fee codes attached ie. special visit premiums (SVPs). SVPs are only eligible for payment with certain parent service codes and pursuant to the rules set out in the Schedule of Benefits. […]
