OHIP billing through Dr-bill.ca – The Ultimate Billing Guide

New physicians in Ontario 

Whether you’re a recent grad who has just completed your residency, or you’re a seasoned physician coming to Ontario from another province, there’s a lot you need to register for before you can legally practice medicine.

In order to help you, we’ve put together a quick guide that walks you through everything you need to do before you can start working. Each step is outlined in the order that you need to complete them, so just follow along and check them off as you go. 

1. Register for your Independent Practice license
2. Apply for an OHIP Billing Number

3. Set up Your “GO Secure” & MC EDT Account

4. Register with WSIB

5. Apply for Hospital Privileges
6. Join the Ontario Medical Association (OMA)

1. Register for your Independent Practice license

Having your independent practice license in Ontario is what allows you to diagnose and treat patients, order investigations, obtain and write prescriptions and essentially practice unsupervised.

The license is a 5-digit number that registers you with the College of Physicians and Surgeons of Ontario (CPSO). This typically takes 3 months to get, so you need to apply for it right away. 

Step 1: Create a ‘PhysiciansApply’ Account   

Create an account with physiciansapply and make sure you add your personal contact information.

Step 2: Request Access  

Once you have an account, email inquiries@cpso.on.ca to request access to the application. In the email you’ll need to attach a ‘review of qualifications’ along with your CV. 

Important Reminder: In order to receive an invitation, you need to have a physiciansapply account and you need to have at least 1 document uploaded (so that the CPSO can view your account information and add the application). When you’re finished your application, it will be sent electronically to the CPSO.

Step 3: Upload Supporting Documents + Apply

Your information will be reviewed by the CPSO staff (generally within 3 business days) in order to determine if you’re eligible to apply. If you are eligible, you’ll receive an email from the College granting you access to the online application (the application will show up in your physiciansapply account). The email will include more details about timelines, fees and supporting documents.

Step 4: Waiting for Acceptance

Once you get approval you’ll receive an acceptance email detailing licensure fees and how you can make payments. Approval takes anywhere from 4-7 weeks.

2. Apply for an OHIP Billing Number

Once you have your CPSO number you need to register for an OHIP billing number. Getting your OHIP billing number typically takes anywhere from 4-6 weeks, so make sure you do this as soon as you get your CPSO number and have a job offer. 

*you can start working without a billing number, but you won’t get paid until you have it. 

Registration Steps

  1. Complete and sign the Application for OHIP Billing Number for Health Professionals form

  2. Attach a copy of a blank cheque with “VOID” written on it (in order to set up direct deposit)

  3. Attach a copy of a valid Certificate of Registration with a governing body

There are three ways to submit your application, by email, fax or snail mail.

By email

Scan originals and send by email: MOH-L-SSU-Registration@msgov.gov.on.ca

By fax

Fax originals to: 613-545-5848

By mail

Ministry of Health and Long-Term Care

Claims Services Branch

Provider Registry Unit

P.O. Box 68

When your application is processed you’ll receive a letter from the Ministry of Health that contains your OHIP billing number and details on the next steps – registering for GO Secure, Medical Claims Electronic Data Transfer (MC EDT) and Health Card Validation (HCV) services.

3. Set up Your “GO Secure” & MC EDT Account

Go secure is the official system Ontario uses to access Ontario Public Services online. It’s where you have access to the Medical Claims Electronic Data Transfer (MC EDT) system that allows you to share data with the Ministry. If you plan on submitting claims electronically, you will also need to designate a software system that is authorized to upload and download files for you.

You can complete these 3 things relatively at the same time, but in order to complete your account setup, you need to have already received a registration letter from the Ministry of Health. This letter contains two ‘unique identifiers’ or codes, that you’ll need to enter during the setup process. 

Go Secure

Setting up your Go Secure account is fairly easy, just head over to the GO Secure login page and click ‘Don’t have a Go Secure account? Register Now’. Then, follow along with the steps.

Enrol in MC EDT

After you have your Go Secure set up, you need to enrol in the MC EDT system to submit claim files to OHIP. To do this, login to your Go Secure account, then select “New User,” then follow along with the instructions.

Make sure you have your OHIP registration letter with the two unique codes.  

Designate a Billing Service

Now that you are registered with Go Secure and MC EDT, you need to connect it to a billing software who can submit claims and download OHIP reports for you.

***If you don’t designate a 3rd party software system, you need to log into Go Secure each time you create a claim and manually upload/download files. Regardless, you will still need a 3rd party software system to create the correct claim file for submission, as the file needs to meet certain technical specifications.

Setting up your Go Secure Designee is a 2-part process:

(Steps 1 through 4)

(Steps 5 & 6)

4. Register with WSIB 

The next step is to join The Workplace Safety and Insurance Board (WSIB) in case you treat a patient who has been injured at work.

There are 2 ways that you’ll get paid for WSIB claims;

  1. Insured Services

    Submit a claim to OHIP like you normally would (using OHIP fee codes) except on the claim you’ll indicate “WSIB.” OHIP will then pay you for your services and bill WSIB accordingly.

  2. WSIB Forms

    When you fill out a form, you bill WSIB. You need to upload these claims directly to WSIB through the online portal Telus Health. These claims have different fee codes than OHIP. The fee codes outline which form you’re using.

WSIB Physician Fee Schedule 

How to register: 

In order to submit both claims to OHIP and WSIB you need to register first with Telus Health. Follow this link and its online instructions.

5. Apply for Hospital Privileges

If you are going to be working in a hospital, whether full time or occasionally, you will need to apply for privileges in accordance with the by-laws of the individual hospital.

These bylaws and rules were established to ensure that Ontario hospitals maintains a high level of care when it comes to the qualifications and competency of its healthcare providers. Having privileges also means you have legal rights to use the hospitals resources and its facility.

Applications for hospital privileges are done directly through the hospital. It’s best to call the hospital where you intend to work and ask them about their application process. Typically, a hospital administrator will assist you with the application. Once you apply it will be reviewed by the hospital and on approval, you will have privileges to practise at that hospital.

In general, you’ll need to apply with photocopies of the following credentials:

  • medical licenses,
  • malpractice certificates,
  • immunization records,
  • CV,
  • Certificate of Good Standing
  • Certificate of Adult Criminal Convictions 

6. Join the Ontario Medical Association (OMA)

The Ontario Medical Association (OMA) represents the political, clinical and economic interests of the province’s medical profession. They are the official voice of medical professionals in Ontario and are a division of the Canadian Medical Association.

Membership is mandatory for physicians practicing in Ontario, and you’ll receive a discount as a first-year physician. Benefits include practice advice, special rates and discounts.

First year Membership Fee: $670 (or $57.08 monthly payments)

Apply Online Here

Find out more about their prices here: 2019 Fee Category Schedule

In closing… 

At first glance the registration process can seem daunting as it evolves a lot of different steps to make sure you’re completely certified and set up to practice. The most important thing is to start the process right away so that your able to start working and your payments are on time. 

Author: Courtney L. works at Dr. Bill (a medical billing app) that lets you skip the paperwork, boost productivity & earn more. If at any time you’d like to reach out or ask for more information on specific topics, don’t hesitate to contact her at courtney@dr-bill.ca, or check out the Ultimate OHIP Billing Guide for more.