How to bill insurance or use direct payment for patients and procedures not covered by OHIP
The following instructions apply to these forms of payment:
- Private invoice (direct pay) to the patient or 3rd party insurance
- RAMQ to Quebec patients
- UHIP (Sunlife) to University and College students.
Patients from BC, AB, MB, SK, and the Maritime provinces can be submitted through our system electronically - how to bill out of province patients.
However, patients who: will pay you directly; have a 3rd party insurance, or are from Quebec need to be billed manually through a paper form and then physically mailed. Our system allows you to pre-populate the appropriate forms based on the claim information you have already entered in our platform.
Private Invoice (Direct Pay)
Follow the Five steps:
Step 1: Complete the "Form & Document Details" section
(if you have completed this step, go to Step 2)
The details you enter will be pre-populated in the PDF forms. This should be your business/practice address where patients or insurance can send you payment.
Top Right --> Settings --> Form & Document Details
Step 2: Select the claim by entering the Accounting ID.
Only claims in Unsubmitted, Submitted, Rejected, Saved, or Archived status can be selected (claims in Adjusted Payment or Paid status have been processed by OHIP, so you can not claim OHIP and also invoice the patient or insurance company).
Step 3: Populate the form & generate the PDF form
Follow the instructions on the page. Select the code(s) you want to include in the form.
Step 4: Review PDF form
The form is created in "fillable" PDF. Complete any missing information (patient's insurance #, etc..), save, and print.
Step 5: Mail the form
Directly to the patient's address, or 3rd party insurance
Régie de l'assurance maladie du Québec
Service de l'application des programmes (Q037)
Case postale 6600
Sun Life Assurance Company of Canada
PO Box 2015 STN Waterloo
Waterloo ON N2J 0B1