Ontario Billings Notice - 7 Feb 2000

This notice covers the following:

1. Ontario Billings --> Billing Submission Order
2. Ontario Submissions --> Printing Manual Review Forms to go with Electronic Submission

1. Ontario Billings --> Billing Submission Order

There are certain HSCodes that OHIP will not pay if they are not submitted after another HSCode. In several cases you can submit them in the proper order by using the Modifier capability in MediFile. In other cases this will not work as there are several extra codes that need to be submitted. The ability to do this has now been added and is covered in this document.

Bill Daysheet

In the Bill Daysheet the order of submission is handled for you automatically. The only thing you need to do is to ensure that you enter the HSCodes in the order that you want them to go in.

Therefore if you enter a A007A;G273A for a patient 2 billing records will be created. These are created when you click on the Bill button in BillDaysheet. The first Billing record created will be A007A. It will get a BSeq of 0. The next billing record will be for G273A and it will get a BSeq of 1. When these billings are sent in A007A will be sent in first, and G273 sent in second. This is because MediFile will sort the billings before sending them in. They are sorted by the BSeq field.

If you enter a two or more HSCodes and then later realize that you have entered them in an order that is incorrect and cause the wrong billing to be sent in first you can correct this. You can correct this in the Billing --> Other Billing screen.

Just call up the Other Billing Screen. Search for the patient. Double click on the billing you want to change the BSeq for. The BSeq field is located just above the total field. Change the number and then click on the Update button. You can use any number between -32,000 and 32,000. It does not matter which number you use, except that when sending the billings in the smaller numbers will be sent in before the larger BSeq numbers.

Other Billings

There is a minor change in this screen. The change is to show the BSeq for each billing. The new areas are pointed to in the screen shot shown here.



This is a screen shot of the top left area of the Billing Hx for one patient. The order that a billing will be sent into OHIP is shown here in the BSeq column. Therefore if there are 4 billings. If two are for one doctor and 2 for another then the order indicated in the BSeq column indicates the order they will be sent in within each doctor’s batch.

Example:

Doctor HSC BSeq Order Sent in Batch
123 A008A 1 1 1
123 G372A 2 2 1
144 A007A 1 3 2
144 G372A 2 4 2

As was shown previously, the location of the field to indicate the order that a billing will be sent in is just above the total field.

When a billing is initially created it will have a BSeq of 0 (zero). A value of zero is OK. If there are more than one billing with a BSeq of zero then the order will be random within that doctor’s batch. In other billing you can see the order of other billings being sent in because they will be shown above in the Billing Hx area.

2. Ontario Submissions --> Printing Manual Review Forms to go with Electronic Submission

When sending in submissions to OHIP electronically you may have marked some billings as needing manual review. Since Feb of 1999 you have been able to print out the manual review text for all the billings that you have marked as Manual Review. Of course you should have entered text in the manual review area.

When entering the billings enter the Manual Review text in the Bill Daysheet, or Other billing areas. Ensure to check off the Manual Review checkbox. The places to do this in each of Bill Daysheet and Other Billing are shown here.

Figure: Page two of Bill Daysheet



Figure: Page two of Other Billing

Generate the Electronic Billing file as you normally would. After each file that you generate go to the billing file and print out the manual review forms. To do, perform the following steps:

1. Click on the popup for Electronic Bill Files and select Create E-Bill File. Follow the steps you have been using to generate the file. You can generate all the files you are going to send into OHIP.

2. Go to the Billing File via page one of the Administrator’s Corner.

3. Using the Find button on the button bar on the bottom find all billings that were sent in on the current date.

4. This search will find all the billings you sent in for all the files you created today.

5. From the Productivity Menu select Custom Reports

6. Select the ON Manual Review Forms

7. Click OK to generate the forms.