OHIP Billing Tip #34 - Stale Dated Claims


Submitting Stale Dated Claims

All OHIP Claims should be submitted to MoH within 6 months from the service date, if 6 months deadline is missed claims become stale. Stale dated claims will not be accepted by the Ministry if you do not receive prior approval.

Please note that you must first send a written request to the MOHLTC Claim Services Branch Manager before submitting stale claims (which are any claims that are over 6 months old). 

If the approval is received and you are advised to resubmit the claim by your MoH Claim Assessor, you can submit the claim as a Manual Review. When a claim is over 6 months old, checking the Manual Review indicator (see screenshot below) will flag the claim as stale-dated and will be transmitted through the SDC (Stale Dated Claim) process, as opposed to the regular manual review process.

Manual review checkbox for stale dated OHIP claims

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

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