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How to Bill E405 Retroactively

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How do I bill E405 retroactively for the procedures that have been paid?

On our system, E405 is required to be billed with a parent service as it requires one in order to determine the fee of 30%. Additionally, billing the premium with the parent code will allow our users to more easily reconcile or check that the fee has been paid properly.

You can create a new claim with the parent code(s) and add the E405 premium to these services.  If the parent services have already been submitted/paid, the MoH should recognize that and only process and pay the premium on the claim.

Please note the premium should be submitted as E405A as the MoH system does not recognize E405C.

If you login to your account from a computer, we have a clone feature available when you select the claim/accounting ID to open and review the claim details.  This feature may be useful when adding the E405 premium to previously submitted claims. As the code requires a master number, you will need to select a facility (where the services were conducted) on the claim.

How to duplicate an OHIP medical claim. Duplicate claim icon highlighted.

 

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