Billing at 85% for Surgical Procedures


How to Bill at 85% for Surgical Procedures

When more than one procedure is carried out by a surgeon under the same anesthetist or within 14 days during the same hospitalization for the same condition, the full benefit applies to the major procedure and 85% of the listed benefit(s) applies to the other procedure(s) performed unless otherwise stated in the Schedule of Benefits.

Users have the option to configure the multiple in the system.  Please go Settings (under username) -> Select “My Preferences” on the left menu. settings menu Set your medical billing preferences

Once there scroll down to “SPECIFIC TO MEDICAL DISCIPLINES”, enter a percentage value in the "Enable Apply at X Percent" field. Leave the value at zero (0) to disable this feature.

The user will then be able to go into their claim and click the button on the right side of the service "Apply at 85%"

Apply a medical claim at 85%

There is a video tutorial that teaches you how to do this under HELP -> Advanced Tutorial -> "Surgical Feature".

Advanced medical billing tutorials

For more billing tips, please check out our OHIP Billing Tip Library.

Questions? Check under the HELP tab or send an email to


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