Guide

Chapter 3:
How to Maximize Your Billing Potential

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Research by the CMA indicates that physicians don’t bill for at least 5% of the insured services they provide. This chapter will help you avoid some of the common challenges that lead to underbilling for your work.

3.1 Track Your Income

Staying connected to your income is an important part of ensuring you are being paid accurately for the services you perform. 

Check out the full version of our OHIP Billing Guide for the pitfalls you should watch out for when outsourcing billing to a third party.

“I appreciate how the dashboard gives me an instant snapshot of how much I’ve billed, how much is pending and the value of claims Dr.Bill has recovered on my behalf.”

Dr. Daffer Ghanim, Emergency Medicine

3.2 Add Applicable OHIP Fee Premiums

If you don’t bill applicable OHIP premiums on top of your regular fee codes, you could be doing a lot of work you’re not being paid for. 

In the Ultimate OHIP Billing eBook, we’ll dive into the parameters for applying the three most commonly used OHIP fee premiums:

  1. OHIP Special Visit Premiums
  2. The Chronic Disease OHIP Fee Premium
  3. Anesthesia Age OHIP Fee Premiums

3.3 Bill For Telephone and E-Consultations

Many doctors engage in telephone and e-consultations, yet neglect to bill for them, which adds up to a lot of unpaid time.

Both the referring physician (the doctor who initiates a call) and the consultant physician (the doctor who receives the call) can bill OHIP for telephone and e-consults. For the most part, as long as your phone call takes place in Ontario, and includes at least 10 minutes of patient-related discussion resulting in a clear recommendation, the consultation qualifies to be claimed by both physicians. 

Did you know?

Doctor-to-doctor telephone consultations as short as 10 minutes in duration are eligible for payment by OHIP. 

3.4 Avoid Rejected Claims With These Tips

Claims can be rejected, refused or reduced for a variety of reasons—from a simple patient information error to incorrect use of a code. The good news is that many of these claims can be remedied and resubmitted for payment. 

The process of investigating, correcting and resubmitting claims can become arduous for physicians doing their own billing. As a result, some physicians simply end up letting some or all rejections go, which can add up to a lot of lost revenue over time.

In the Ultimate OHIP Billing eBook, we’ll review the five most common reasons for rejected claims. When you keep these in mind, you’re likely to experience fewer unpaid claims.

Did You Know?

Dr.Bill users receive proactive alerts before claims are submitted to prevent many common errors.

3.5 Use OHIP Billing Best Practices

With years of OHIP billing experience under our belts, we have some no-nonsense tips to share to help you maximize billing and ensure timely payments.

In this section, we’ll cover how frequently physicians should submit claims, tips for avoiding audits and much more.

Never Miss an OHIP Submission Deadline

Did You Know? You can sign up for our OHIP cut-off alerts and receive a reminder 2 days prior to the OHIP claims cut-off date each month.

Chapter 4: Creating an Efficient and Fulfilling Practice

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