Here are some instructions on how to bring your MOH reports into OSCAR using the MCEDT Mailbox, and how to fix corrections to have sent back to the MOH for payment.
Invoice Status:
O Bill OHIP: when an invoice is created, it will be in the status of Bill OHIP (or Invoiced in the Invoice Reports). After an invoice is corrected the Billing Status must be in O Bill OHIP to be included in the next submission.
B Submitted OHIP: when an invoice is included in a generated claim file, the status will be updated to B Submitted OHIP. It will remain in this status until a payment is received, and it is marked as Settled during the RA processing.
S Settled/Paid: when an invoice has received a payment on the Remittance Advice and the RA is processed within OSCAR, the invoice status would be updated to Settled/Paid.
Reports are available for download anywhere from 24-72 hours after a claim file has been uploaded to the MOH. A Batch Acknowledgement would be available for download first, as confirmation that the MOH has received your generated claim file. Error Reports would come second, if there are any invoices rejected.
Downloads are obtained by navigating to Administration > Billing > MCEDT Mailbox. Here you would select the Download New Files button in green. It will flash on your screen any new reports that are being downloaded, which will be available under View MOH Files once download is complete:
Here is a link to a video that covers obtaining your downloaded reports: How to upload and download reports using the MCEDT Mailbox
Corrections can be done a couple of ways within OSCAR, either way can be utilized. Both methods will have the Error Reports available under View MOH Files to action after downloaded from the MCEDT Mailbox.
One way would be searching by Invoice Number within Billing Corrections located on the left side under the Billing tab of the Administration panel. The second method would be to run a Rejected Invoice Report.
First, the Error Report would need to be opened from View MOH Files. The Error Reports start with the letter E and will contain the physician's billing number within the report name.
The Error Report will contain all the information from the invoice including - patient info, referral info, invoice number, service codes, service date, units, fee and of course the code or claim errors:
Billing Corrections:
Using the Billing Corrections method, the Invoice Number can be copied from the Error Report, and then pasted into the Billing Corrections search to load. Alternately, there is also a print option on the Error Report as well. This method is best if you do not receive a lot of rejections and managing a one or two physician clinic.
Depending on the error code received, will determine what is corrected on this page. For instance, any rejections surrounding the patient's information must be corrected in the patient Master Record first. This will ensure that any future billings created for this patient will not receive the same rejection. Below is an EH2 correction example. Here is a link to a video completing an EH2 correction: EH2 Error Corrections
EH2:
The patient name would need to be clicked to open their Master Record. From the new window the Edit button would be clicked to open the Master Record to make modifications:
The version code can be updated within the Master Record, and Update Record at the bottom of the window to save your changes:
Once updated the Master Record window can be closed, this will bring you back to the Billing Corrections page, where the Update and Bill button would need to be utilized:
The Billing Status will then be updated to O Bill OHIP, so that the invoice will be included in the next simulation.
A Rejected Invoice Report could be run to allow you ability to complete multiple corrections without having to search one by one. This method is great for a clinic that receives a lot of rejections, or manages a multiple physician clinic. Here is a link to a video covering Rejected Invoice Reports: Rejected Invoice Reports
After downloading the Error Reports, and opening the reports under View MOH Files, you may then navigate to Invoice Reports to work on the corrections. Here a provider, or ALL Providers can be selected, and a Service Date range entered. The option of Rejected would need to be selected, and then Create Report:
Please note that if an invoice was received on an Error Report, it will always be present on this Rejected Invoice Report. The status of the invoice may be updated to Settled once paid, but it will still be included in the Rejected report.
The generated report will contain the same information as the Error Reports from the MOH. There will also be a column for the Invoice Status - so you can visually see if it has been marked as Settled (S), or recently corrected and set to Bill OHIP (O). Furthermore, there is also a Checked column, where you can place a checkmark after you have corrected the invoice:
The Invoice Number can be clicked to open the invoice to perform the correction:
AC4:
For an AC4 or ARF error regarding the referral doctor information on the invoice, the magnifying glass would need to be clicked to search your specialist list for the correct referring provider:
Once located, the Update and Bill button would be used on the invoice page to update that information, and set the Billing Status back to O Bill OHIP:
On the Rejected Invoice Report, we can then place a checkmark beside the corrected invoice:
After completing any error correction, the Billing Status must be set to O Bill OHIP to ensure that it is included in the next submission.
It is best to complete a submission after completing the corrections - the service date range entered should include all dates of services that were recently corrected. We recommend 3 months back for the stale dated cut off with the MOH. Check out this link for a video on how to create a file for submission: How to simulate and generate an OHIP file
If you have any questions regarding an error received, you may contact a MOH representative at 1800-262-6524.