What is a shadow billing claim?
A shadow billing claim is one that returns as paid at $0, or at a specific percentage of the claim value. OHIP returns the code “I2” on shadow billing claims.
What is an “I2”?
If your group number is part of an Alternate Funding Plan, only a percentage of the claim amount is paid. These types of payments are listed as “I2 - Globally Funded”. This means the claim was paid to the group but the OHIP system isn’t capable of returning the actual amount that was paid since every AFA agreement is different. Therefore, they show as paid at $0.
Why does a shadow billing claim need to be invoiced on the submitted value, instead of the paid value?
Due to limitations in the information OHIP can return to Dr.Bill, claims must be invoiced based on the submitted claim value. Since OHIP returns these showing the paid amount as $0, invoices are unable to be correlated with the paid claim value.
When will this take effect?
This pricing will apply to all claims submitted on or after Nov. 18th, 2025, which will first reflect on your January 2026 invoice.
Can I enter both fee-for-service and shadow billing claims in the same Dr.Bill account?
Yes. If you have been using two separate Dr.Bill accounts to keep shadow billing and fee-for-service separate, you have the option of submitting both types of claims within the same account moving forward.
Can I select a different plan for shadow billing and fee-for-service?
No. The same plan and rate will be applied to both shadow billing and fee-for-service claims.
Still have questions? Please write to our team at hello@dr-bill.ca for further assistance.
Happy Billing!