Understanding Your OHIP Remittance Advice

Every month, OHIP sends you a Remittance Advice (RA) through the Medical Claims Electronic Data Transfer (MCEDT) system. This document is your billing statement — it shows what was paid, what was rejected, and what was adjusted.

If you're not reviewing your RA regularly, you're likely leaving money on the table.

What's in an RA?

Your Remittance Advice contains several key sections:

• Paid claims: Claims that were accepted and processed at the Schedule of Benefits rate
• Rejected claims: Claims that OHIP couldn't process, with error codes explaining why
• Adjusted claims: Claims where OHIP paid a different amount than what you billed (e.g., fee reductions, maximum limits)
• Summary totals: Your gross billings, deductions, and net payment for the period

Common RA Error Codes

When a claim is rejected, the RA includes an error code. Here are some you'll see frequently:

| Code | Meaning | |------|---------| | AD | Duplicate claim — already paid | | AE | Invalid health card number | | AF | Service not eligible for patient's coverage | | V1 | Diagnostic code invalid for this fee code | | EG | Exceeds frequency limit |

Each rejection is an opportunity to correct and resubmit — if you catch it within the 6-month window. For a deeper dive into preventing these, see 5 Ways to Reduce OHIP Claim Rejections.

Reconciliation: Why It Matters

Reconciliation is the process of matching your RA payments back to the claims you submitted. Without it, you won't know:

• Which claims were paid at the expected rate
• Which rejections need resubmission
• Whether your total payments match your expected billings

Many physicians skip reconciliation because it's tedious. That's a mistake — unreconciled accounts consistently show 3-5% revenue leakage. If you're thinking about switching billing platforms, reconciliation capabilities should be at the top of your checklist.

How SnapBill Handles Reconciliation

SnapBill automatically downloads your RA files, matches payments to submitted claims, and flags discrepancies. You get a clear dashboard showing:

• Paid vs. expected amounts
• Outstanding rejections with suggested fixes
• Trends in your rejection rate over time

No spreadsheets. No manual matching. Just a clear picture of your billing health.

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Stop guessing what OHIP paid you. Start with SnapBill and get automatic reconciliation from day one.