How to bill insurance or use direct payment for patients and procedures not covered by OHIP

The following instructions apply to these forms of payment:

Private invoice (direct pay) to the patient or 3rd party insurance
RAMQ to Quebec patients
UHIP (Cowan) to University and College students.

Background:

Patients from BC, AB, MB, SK, and the Maritime provinces can be submitted through our system electronically - how to bill out of province patients.

However, patients who: will pay you directly; have a 3rd party insurance, or are from Quebec need to be billed manually through a paper form and then physically mailed. Our system allows you to pre-populate the appropriate forms based on the claim information you have already entered in our platform.

Private Invoice (Direct Pay)

Follow the Five steps:

Step 1: Complete the "Form & Document Details" section

(if you have completed this step, go to Step 2)

The details you enter will be pre-populated in the PDF forms. This should be your business/practice address where patients or insurance can send you payment.

Top Right --> Settings --> Form & Document Details

Video of how to set up a private medical bill in Ontario

Step 2: Go to REPORTS & FORMS -> Select the insurance type -> Select the claim by entering the Accounting ID.

Only claims in Unsubmitted, Submitted, Rejected, Saved, or Archived status can be selected (claims in Adjusted Payment or Paid status have been processed by OHIP as you cannot claim OHIP and also invoice the patient or insurance company).

Input the accounting ID of the medical claim

Step 3: Populate the form & generate the PDF form

Follow the instructions on the page. Select the code(s) you want to include in the form.

Step 4: Review PDF form

The form is created in "fillable" PDF. Complete any missing information (patient's insurance #, etc..), save, and print.

Step 5: Mail the form

Private invoice - Directly to the patient's address, or 3rd party insurance

RAMQ (Quebec)

Régie de l'assurance maladie du Québec
Service de l'application des programmes (Q022)
Case postale 6600
Québec (Québec)
G1K 7T3

UHIP (Cowan)

Cowan Insurance Group
700-1420 Blair Place
Ottawa, Ontario
K1J 9L8

Private Invoice(Direct Pay) - Tracking Payment

1. Once you have entered the services into the Private claim and generated the invoice select -> "Save and Submit". The status of the claim will change to “Private Claim”. This status will list outstanding Private claims not yet paid.

2. To reconcile the Private claim after payment is received the claim can be archived. You can enter notes into claim comments.