Automatic Percentage Premium Matching


Automatic Percentage Premium Matching

You will notice the % premium selection box is now hidden.

Our system will automatically match the percentage premiums with the parent codes based on the rules from the OHIP Schedule of Benefits.

Simply add the parent code(s) first and then the % premium.

For example, if you want to bill A135 + E082 (MRP admission premium):

  • Step 1: add A135A + Dx code + Date
  • Step 2: add E082A

(no need to manually match E082 to A135)

Parent and % Premium code combination not eligible

If the % percentage premium is not eligible with the parent code, the system will not match the codes (ie. A133 + E083 are not eligible) and will prompt you if you want to override and manually match the code.

Percent matching not eligible

Edit code matching

You can always edit the match by selecting ACTION on the % premium code and then EDIT. This is useful when you have multiple parent codes.

Matching code percent manual override

Fixed premiums

For fixed premiums (ie. special visits: C99x/K99X/W99X, etc.) you do not need to match to a parent code, as their fee value is not dependent on a parent code.

Algorithm updates

Our matching algorithm is about 95% accurate as the OHIP Schedule of Benefits is constantly changing. Feel free to send us an email to with your code combinations and we will update our system accordingly.

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