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OHIP Billing Tip #34 - Stale Dated Claims

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Submitting Stale Dated Claims

All OHIP Claims should be submitted to the MoH within 6 months from the service date, if the 6 months deadline is missed claims become stale. Please note that you must first send a written request with explanation of delayed submission to the MOHLTC (ClaimsManagement@ontario.ca) before submitting stale claims (which are any claims that are over 6 months old). A Claim Services Branch Manager will review the letter and approve or deny your request.

When attempting to submit a claim that is over 6 months old, a pop-up window will show when you click the Save and Submit button.

  • If the stale dated claim approval is received and you are advised to submit the claim through the “stale dated claim process” by the MoH, you can select the option “I have obtained MOH approval to submit this claim as stale dated” and submit the claim.mceclip3.png

 The system will visually mark on the claims page that the record is stale dated.

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  • If you are advised to submit the claims through the regular process (i.e. not to flag the claim as “stale dated”), please select the option: “I have not obtained MoH approval and would like to submit this claim through the regular process” and submit the claim. mceclip4.png

Note: Please make sure a batch number is received after 3 days of submission. Otherwise, contact the Ministry to confirm if the claim is received. 

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

Questions? Check under the HELP tab or send an email to support@mdbilling.ca

 

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