Unprocessed Stale Dated Claims


What is the Stale-dated Claims Process

I am just looking at my unprocessed claims. Why are they unprocessed? Just wondering - there are 3 old claims totalling $405.27. 

Good morning Dr. D,

We noticed the unprocessed submitted claims in your account were submitted (or resubmitted) after they became stale-dated (submitted 6 months past the service date).

Please note that prior to submitting a stale-dated claim, you must first send a written request to the Ministry of Health claims services Branch Manager. Only once you receive the written approval from the Branch Manager, you can then submit the stale dated claims. The stale dated claims will not be accepted by the Ministry if you have not received prior approval.

If you wish to submit a letter to request approval to submit these claims, please call the phone number listed below for your assigned MOH branch office and they will be able to provide you with the direct phone number/email for the MOH Branch Manager to address your letter to:

Ministry of Health District Branch Offices:
Tel: 416-314-7770 Fax: 416-314-7518
Tel: 905-576-2870 Fax: 905-434-4186
Tel: 905-521-7547 Fax: 905-546-8287
Once you have received approval and have resubmitted a claim, you would need to follow-up with the Branch Manager who approved the submission, and the Branch Manager will need to manually retrieve the claim within their system and then pass the claim to your Claims Assessor to process.
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