OHIP error code – HCE-HCE Enrolment after 3 months

Background

A claim will be rejected with code "HCE" for one of the following reasons:

• If the physician bills the Multiple/Newborn Fee (Q055A) and the newborn is not enrolled within three (3) months of birth
• If the physician bills the HCC Upgrade Patient Status (Q056A) FSC for a patient that is not
  enrolled within three (3) months of the HCC referral date
• If the physician bills the HCC GT Three Months (Q057A) FSC for a patient that is not enrolled
  within three (3) months of the HCC referral date

Solution

Contact the Home Health Care Coordinator at your local LHIN to confirm patient is registered on Health Care Connect (HCC).

For more information, please refer to Billing & Payment Guide for Family Health Organization (FHO) Physicians