Here is a link to a video in our Help Portal: How To Make An Invoice For OHIP Using The New PRO Experience
Accessing The Invoice Creation Page:
- From the eChart of the patient and using the Sign Save & Bill button ($)
- Clicking on the B link from a scheduled appointment
- From the patient's Master Record (M) and along the left side under the Billing tab, Create Invoice
- Clicking on Bill from a lab result
- Enabling a B link on a patient search from your Billing Settings
Please note that how you access the billing screen is dependent on your workflow.
The appointment status will only update to the Billed status if options 1 and 2 are utilized from above, other wise the appointment status will remain in the last status and would need to be manually updated to Billed to reflect the saved invoice, if required for visual aid.
Creating An Invoice For OHIP:
When accessing the billing screen from either the eChart, or the B on the appointment - some aspects of the invoice will automatically be filled - such as the Billing Provider and the Service Date:
When billing to OHIP the Billing Type should be set to Bill OHIP. Billing Forms can be modified to load a specific Billing Type. For example, when using the General Practice Billing Form, the Billing Type will display as Bill OHIP. Here is a link to a video covering billing forms from our Help Portal: Billing Form Management - ON
The Visit Type, Site Number and SLI Code will be defaulted to "Clinic Visit" and "Not Applicable," these can be changed with the drop down options available if required:
When opening the Invoice Creation page, if the patient does not have an HIN in their Master Record, a red X will be present beside the patient's name:
Along the right hand side above the Billing Form, there is an option to turn on the service code descriptions as well as the fees of the codes to be displayed. Once this setting is enabled, it will remain on until disabled by the provider:
Now to begin creating the invoice.
For Specialist billing, the provider will want to enable a Billing Setting to auto-populate the Referring Doctor information from the patient's Master Record. This setting is applied by the provider, and can be enabled from the Gear Shift located in the top right corner of the invoice creation page:
Under General Settings is option to include the Referring Practitioner's information:
This setting is only required for those that need to include the Referring Doctor's information on the invoices for the MOH.
Service Codes need to be included and can be added to the invoice page a number of ways. A service code can be searched using the Service Code box, where the service code will begin to populate based on the typed entry for you to select. This can be done by entering in a service code, or by searching for a service code description:
Please note that an improvement was applied to not permit entering in service codes without the letter at the end, ensuring no rejections for invalid service codes.
Service codes can also be selected from your billing form along the right hand side. Once a code is selected, it will be highlighted on the Billing Form as a visual aid:
Next is the Dx box, where you can add a diagnostic code if necessary, this can also be added a number of ways. First, if the patient has a diagnosis entered in their Disease Registry in their eChart, options will display for you to select:
Similar to the service code box, you can start typing directly in the box by either numeric, or by description and a list of Dx codes will begin to populate for you to choose from. For example, if adding Diabetes we can type in 250, or begin typing in Diabetes:
Lastly, a list of Dx codes associated with the Billing form loaded can be viewed by accessing the Gear Shift for the Billing Settings page:
Please be aware that after selecting a Dx code the window will not close automatically, you will want to click the X in the top right corner to close the Billing Settings window. You will then note that the Dx code selected is now populated on your invoice.
Furthermore, the additional Diagnostic Code boxes that appear beside the service codes in the centre of the invoice page. If you need to assign more than one Diagnostic Code on the invoice, this may be done per service code. Alternately, the default Dx code entered at the top will apply to all the service codes selected, unless a different code is entered:
The number of units will default to 1, and the percentage can remain blank, which is the default for 100%. The Units and Percentage can be adjusted as necessary. Once you've completed the service code entry you can Save and Close:
The saved invoice would be in the O Bill OHIP status and ready to be included in the next Simulated and Generated claim file. Click here to watch a video from our Help Portal on how to create files for OHIP: How To Simulate and Generate an OHIP File
Invoice Statuses:
O - Bill OHIP, a newly created or newly corrected invoice set back to Invoiced status
B - Submitted OHIP means the invoice has been included in a generated claim file but not marked as paid yet on a RA report
S - Settled/Paid means it has been updated to Settled after receiving payment on a Remittance Advice during processing of payment report