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Health Care Provider Billing for Completion of ODSP Application Forms and introduction of the Online

January 7, 2020   (0 Comments)
Posted by: Tiffany Budhoo
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Please see below for an update re. Health Care Provider Billing for Completion of ODSP Application Forms and introduction of the Online Medical Invoice Form: Click here to view the official memo

 

We are writing to provide an update to all healthcare providers (HCPs) who complete the Ontario Disability Support Program (ODSP) application forms for their patients.

 

The Ministry of Children, Community and Social Services (the ministry) pays HCPs for completing the Disability Determination Package (DDP), Medical Review Package (MRP) and for providing additional medical information when requested by the Disability Adjudication Unit (DAU).

 

As outlined on the application forms, physicians completing ODSP forms, must directly bill OHIP.  Using this mode of billing ensures a faster and more efficient processing of fees. 

 

Effective immediately, the DAU will no longer accept invoices from physicians who have access to OHIP billing for completing the forms noted below.

Only HCPs who cannot bill OHIP may bill the DAU directly using the new online invoice.

 

OHIP Billing for DDP and MRP

 

Physicians completing one or both forms must directly bill OHIP using the fee schedule codes noted in the tables below.

 

Table 1

Disability Determination Package (DDP)

OHIP Code

Fees

Completion of DDP -Both HSR and ADLI

K050

$100

Completion of -Only HSR

K051

$80

Completion of –Only ADLI

K052

$20

 

Table 2

Medical Review Package (MRP)

OHIP Code

Fees

Completion of Medical Form Part A

K057

$35

Completion of Medical Form Part B -Both HSR and ADLI

K058

$125

Completion of Medical Form Part B -Only HSR

K059

$100

Completion of Medical Form Part B -Only ADLI

K060

$25

 

 

Online Medical Invoice for Non-OHIP Billing

 

The ministry recognizes that there are some exceptions when OHIP billing cannot be used by HCPs:

  1. HCPs who do not have access to bill OHIP, and 
  2. Payment for Additional Medical Information: there is no OHIP code for providing additional information and photocopies

 

The ministry has developed  a new standardized online invoice form with all the required information that is fast, easy and secure.

Reminder: to be considered complete and to avoid having the invoices returned, all invoices must have the following:

  • HCP’s full name
  • Billing address
  • An invoice number

·       Canada Revenue Agency (CRA) Business Number for the billing party; If HCP does not have a CRA Business Number, please indicate this on the invoice

  • Patient’s full name, Member ID and Date of Birth
  • Service rendered

Please alert all your members of this new online invoice, form 3261, that can be located  in the Ontario Central Forms Repository: www.forms.ssb.gov.on.ca

We appreciate your continued support and the  important role your members play in helping their patients access ODSP income support and benefits.

If you have any questions about the OHIP billing processes and how to access the online invoice, please feel free to contact Ola Kolodij, Senior Manager, DAU, Social Assistance Central Services Branch at 416-212-6752 or at Ola.Kolodij@ontario.ca.

 

Sincerely,

 

Keith Palmer                                                                                                                        

Director                                                           

Social Assistance Central Services Branch