The ‘MC EDT’ Claim Process
About 95% of doctors in Ontario work under the fee-for-service (FFS) model.
Under this model you submit invoices (known as medical claims) of who you saw, and what you did, to the Ministry of Health and Long-Term Care (MOHLTC).
All medical claims get submitted to the MOHLTC through the medical claims electronic data transfer (MC EDT) system. Using this secure system ensures that confidential files (like those that contain patient information) are safe. The MC EDT system is the only way you can submit claims to the ministry.
In order to submit your medical claims, you need to:
Once you submit your claims, the MOHLTC will review them. Upon approval, you’ll be reimbursed for the health care services you’ve provided.
In order to get your claims approved, each claim must outline a health service code, which corresponds to the service you’ve provided. Each service has a specific dollar amount which is how much you’ll be reimbursed for. Fee codes, prices are rules are outlined in the schedule of benefits.
How to Upload your Claims to the MC EDT System
Claim files must be submitted in a specific file format as outlined in the
Technical Specifications-Interface to Health Care Systems manual.
There are 2 possible options to submit claims;
- through the MC EDT web page or,
- through the MC EDT web service.
As you read through both options below, keep in mind that regardless of which one you choose, you still need to sign up with an authorized 3rd party billing system in order to create the correct claim file.
1. MC EDT – Web Page
You can submit your claims directly online to the MOHLTC by logging in on the MC EDT secure web page and uploading each claim.
This web page is very simple, with a web-user-interface that has basic uploading and downloading options. You’ll only be able to upload claims one at a time. Likewise, you’ll only be able to download and retrieve files one at a time.
If you prefer this option, remember that you will still need a 3rd party billing software to create the correct claim file for submission, as the file needs to meet certain technical specifications.
2. MC EDT – Web Service
With the web service, you create claims and upload them to the MOHLTC through the MC EDT system using an authorized 3rd party billing software. Using this integrated software allows you to create and submit multiple claims at a time.
Compared to the MC EDT web page, the MC EDT web service is a more automated system of submitting and receiving claims and is recommended for anyone working more than a few hours a week.
With this option you’ll also have more support and reporting tools such as:
Using the MC EDT web service will allow you to designate your 3rd party billing software to submit and recover claims on your behalf. This is a major time-saver as you won’t have to go through every rejection and submission error and resubmit them yourself.
Designating your billing software also means that they will be able to download and display your monthly MC EDT reports (as shown below).
Remittance Advice Reports
Each month, usually around the 5th or the 7th, you’ll receive a remittance advice (RA) report. This is a detailed report from the MOHLTC that outlines which claims were approved, which ones were paid with adjustment and which ones were rejected.
How you see your remittance report will depend on the software system you’re using to submit claims. Here’s a general example of what your RA report looks like on the Dr. Bill dashboard.
Claims Error Reports
Along with your RA report, you’ll receive a claims error report. Your Claims Error report shows you which claims have submission errors and need to be fixed in order to be paid.
Each claim error is accompanied by a code. You’ll need to look up that code to find the description of the error in order to know what is wrong with it and how to fix it.
TIP: Use this searchable database to find the code from your Claims Error Report.
How to register for MC EDT
In order to submit your medical claims to the MOHLTC through the MC EDT system you need to be an authorized user. In order to be an authorized user, you first need to have a Go Secure account.
What’s the difference between GO Secure & MC EDT?
A Go Secure account is the secure website that allows claim transfers between you and the ministry, while the MC EDT system is the method of actually transferring those claims.
Creating a Go secure account gives you access to ‘Ontario Public Services’ online and the MC EDT system.
You cannot register and enrol for MC EDT without first setting up a Go Secure account.
In order to be able to register for your Go Secure account, then enrol in the MC EDT system, you will need to have an OHIP Billing number.
When you apply for you billing number, and get approved, you’ll receive a registration letter from the Ministry of Health. This letter contains two ‘unique identifiers‘ or codes, these two codes are what you need to register for MC EDT.
If you already have a Go Secure account and just need to register for MC EDT, follow the instructions below. If you still need to register for a Go Secure account, follow along with this article that outlines how to set up your Go Secure account, how to enrol in MC EDT and how to designate a 3rd party billing service.
Otherwise, the exact steps for registering with MC EDT are:
Step 1: New User
Head over to the Go Secure Login and sign in with your password and username.
If haven’t ever set up a MC EDT account before, leave the selection as ‘New User‘. If you’re migrating from the old MC EDT system, select ‘Migrating EDT User,’ then click continue. In most cases you’ll be selecting ‘New User’.
Step 3: Enter Your Unique Identifiers
Remember, these are found in the letter that was mailed to you by the Ministry of Health when you received your OHIP Billing number.
Step 3: Acceptable Use Policy
That’s it, your registration is complete!
Final Steps: Designate your Billing Service
Once you’re enrolled with MC EDT, you’ll need to designate your billing service so that they can submit claims and download MC EDT reports for you.
Note: You can have several designees, for example when you’re billing in multiple places. Adding a new designee won’t affect any existing billing arrangements you have.
Setting up your Go Secure Designee is a 2 part process:
(if you’re using another billing system the steps will be the same, just substitute the name Dr. Bill for the name of the billing software you’re using).
Part A: Add Dr. Bill as a Designee on your Go Secure Account
- (Steps 1 through 4)
Part B: Authorize Dr. Bill to submit claims on your behalf
- (Steps 5 & 6)
2019/2020 Cut-Off Dates for MC EDT Claim Submissions
Once you’re registered and start submitting claims, OHIP runs on a monthly pay cycle. You can expect payment usually around the 15th of each month.
The 18th is the official OHIP cut-off date, which means that any claims you submit up until the 18th of each month will be processed for payment by the 15th of the following month.
Sometimes, claims received after the 18th of the month might still get processed by the end of the month, but to make you get paid on time we suggest submitting before 5pm on cut-off days.
The best way to never forget the MC EDT cut off date is to bookmark or download the OHIP shareable calendar:
Remember, registering for your Go Secure, MC EDT and designating your billing service can all be done at the same time. If you have any questions, or run into any problems during the registration process don’t hesitate to reach out and ask for help.
New to Ontario Billing?
Check out our Ultimate OHIP Billing Guide for step by step on what you need to register for, how to automate your billing, billing tips and more!
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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