For specialist billing, the referral number, also known as an OHIP number needs to be added to the invoice for processing by the MOH. Invoices without a referral number may result in OHIP rejections, such as ARF or AC4.
To avoid rejections, there is a Billing setting that can be enabled to ensure the referral number is added automatically to the invoices.
Prior to enabling this setting, the referral number needs to be added to the EMR and then to the patient's Master Record.
We will go over these steps, here is a link to a video reviewing the process: Adding Referral Info To Invoices
Adding Referral Number To EMR:
Once you've received your referral containing the information of the referral physician, they would need to be added to the system under the Consultations tab.
Here is a link to a video on how to add new consultants: Adding Consultants
This would be done by clicking on Consultations along the green bar, and then Edit Specialist Listings in the top left corner of the new window:
From here, we will click to Add Specialist and fill out all mandatory fields to Add Specialist:
The First Name, Last Name, Address and Phone are mandatory fields. For billing purposes, the referral number needs to be entered - this is the physician's OHIP billing number.
Adding Referral Number To Master Record:
Now that the referral information has been added to the system, we can now link it to the patient in their Master Record. The referral information on an invoice is loaded from the Master Record.
The Master Record of a patient can be opened by clicking M on an appointment, or the demographic number on a patient search:
We will then click Edit and scroll to the Referral Name and Number location:
The Blue links would need to be used to search your database to locate the referral doctor added in the first step. Once the referral doctor has been selected, the information will show in the Master Record:
We would then scroll down and click Update Record to save the changes.
Turn On Billing Setting To Add Automatically:
From the invoice creation page, the Billing Settings would need to be opened from the gear shift located in the top right corner:
From here we need to place a check mark to add referring information from patient chart:
Once enabled, the setting does not need to be turned on again - it will be applied for all invoices created.
Permitting the Master Record contains the referral information, it will be automatically added to an invoice.
Please note that the Billing Setting needs to be enabled per provider. So anyone that is creating invoices and needs the referral information added will need to enable this Billing Setting.