OHIP · Billing integration
Submit OHIP claims in batches and let the remittance post itself.
Ontario clinics bill OHIP electronically and reconcile against a remittance advice from the Ministry. Clinicmaster builds the claim batch, submits it over MCEDT or through ClinicAid, brings back the error reports and remittance files, and posts the payments — so the monthly reconciliation stops being a manual exercise.
The OHIP integration
OHIP is Ontario’s provincial health insurance plan. Clinics submit claims electronically and are paid on a remittance advice cycle. Clinicmaster supports two routes to the Ministry: the direct MCEDT channel, and the ClinicAid billing service — clinics use one or both. In either case the claim batch is built from the work recorded in Clinicmaster, the Ministry’s error reports come back against it, and the remittance advice is parsed to post payments.
What the OHIP integration does.
OHIP billing is a cycle, not a transaction. Clinicmaster covers the whole loop — out to the Ministry, back with errors, back again with money.
Claim batches built from your work
Claims are assembled from the billable items already recorded against visits, then grouped into a batch queue for submission rather than typed into a separate biller.
MCEDT or ClinicAid
Clinicmaster supports the Ministry’s direct MCEDT channel and the ClinicAid service. Clinics use whichever route suits them — the claim preparation is the same either way.
Secured to Ministry requirements
MCEDT exchanges are signed and encrypted as the channel requires, with credentials and certificates held server-side rather than in the app.
Error reports brought back and decoded
Ministry error reports are retrieved against the batch that produced them, with the rejection and explanatory code tables held in the system so a rejection is readable rather than a bare number.
Remittance posted automatically
Remittance advice files are downloaded and parsed, and the payments post against the right invoices — skipping anything already reversed rather than double-posting.
Conformance testing before you go live
A conformance-testing path exists for validating the connection against the Ministry before real claims flow, so go-live is not the first test.
From visit to reconciled remittance.
Claims collect into a batch.
Billable items from the visits you have recorded feed a claim batch queue, where they can be reviewed before anything is sent.
The batch goes to the Ministry.
Clinicmaster submits over MCEDT or through ClinicAid under your clinic’s credentials, and keeps the batch file and the submission together.
Errors and money come back.
Error reports are retrieved and decoded against the batch; when the remittance advice arrives it is parsed and the payments post to the right invoices.
What this integration does not do
OHIP submission is batch and file-based, on the Ministry’s cycle — it is not real-time adjudication, and remittance posts when the remittance file arrives rather than instantly. Note the routing: claims reach the Ministry over MCEDT or via ClinicAid, a third-party billing service, so this is not a bilateral private link. Fee schedules, eligibility and rejection rules are the Ministry’s. Your billing number and MCEDT enrolment are arranged with the Ministry.
What Clinicmaster tracks across the OHIP cycle.
The reason OHIP reconciliation goes wrong is that submission, rejection and payment live in three different places. Here they are all attached to the same batch.
Back to regional billing- Claim batch queue
- Submitted batch files
- MCEDT message exchanges
- Ministry error reports
- Rejection and explanatory codes
- Remittance advice files
- Automated payment posting
- Reversed-invoice protection
- Conformance test runs
OHIP billing questions.
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