From Pager to Paycheque

What this guide covers

The eight registrations a new Ontario physician needs in order to submit claims and receive payment from all the payers you will encounter. Read it in order: each step depends on the one before it.

• CPSO Certificate of Registration
• OHIP billing number
• OPS BPS Secure account
• MCEDT enrolment
• Medavie Blue Cross (federal programs)
• WSIB
• RAMQ (Quebec patients)
• UHIP (international university students)

Scope. This guide is for Ontario physicians beginning independent practice in any specialty. It assumes you have a CPSO Certificate of Registration (or are about to receive one) and that you plan to submit your own claims or use a billing agent.

Step 1: Confirm your prerequisites

You need three things in place before the Ministry of Health will issue an OHIP billing number. Start them in parallel.

CPSO Certificate of Registration

Apply through the College of Physicians and Surgeons of Ontario: cpso.on.ca/Physicians/Registration/Apply-for-Registration. Residents completing training in Ontario can apply for the independent practice certificate three to four months before postgraduate training ends. Physicians moving from another province should allow four to five months for the CPSO Registration Committee review.

Ontario practice address

Use the address of your primary work location: hospital, clinic, or group practice site. A home address alone is not accepted. You can update this later if your primary site changes.

Banking information for direct deposit

OHIP pays by direct deposit only. Prepare a void cheque or a bank letter confirming your account details.

Specialty code. Your OHIP billing number is assigned a specialty code based on your CPSO registration. The specialty code determines which fee codes you are allowed to bill. Confirm the specialty code on the ministry letter you receive in Step 2 and contact the ministry immediately if it is wrong.

Step 2: Apply for your OHIP billing number

Complete the online Application for OHIP Billing Number at forms.mgcs.gov.on.ca/en/dataset/on00574. Ministry reference page: ontario.ca/page/ohip-billing-number-registration.

What to submit

• Completed application form
• Copy of your CPSO Certificate of Registration
• Banking information (void cheque or bank letter)
• Proof of your practice address
• Government-issued photo identification

What you receive back

A letter from the ministry containing your OHIP billing number and the unique identifiers required for Step 4 (MCEDT enrolment). Keep this letter; you will need it twice.

Processing time: typically 2 to 6 weeks, longer during summer onboarding peaks.

Questions: Service Support Contact Centre at 1-800-262-6524, or SSContactCentre.MOH@ontario.ca, 8:00 am to 5:00 pm Monday to Friday.

Group billing numbers

If you are joining a Family Health Organization, hospitalist group, or ED group, the group will also have a billing number. The group lead registers and maintains it. You are added as a member and can bill to your personal number, the group number, or both, depending on the group contract. Confirm which services must be billed where before your first shift.

Step 3: Register for OPS BPS Secure

OHIP only accepts electronic claims. Electronic claims are submitted through the Medical Claims Electronic Data Transfer (MCEDT) service. MCEDT requires an OPS BPS Secure account. This is a one-time registration.

Registration steps

1. 1.Go to ebse.health.gov.on.ca and click "New User Register".
2. 2.Enter your information and accept the Terms of Service.
3. 3.Check your email for a verification link and click it.
4. 4.Sign in with the email address and password you set.
5. 5.Retrieve the 8-digit one-time PIN from a second email.
6. 6.Enter the PIN and click Submit.
7. 7.You should see "Success! Email Verification complete".

Time required: same day, assuming both emails arrive promptly.

Step 4: Enrol in MCEDT

Once OPS BPS Secure is active, enrol your account in MCEDT. Full reference manual: ontario.ca/page/medical-claims-electronic-data-transfer-mcedt.

Enrolment steps

1. 1.Sign in to your OPS BPS Secure account.
2. 2.Select New User from the drop-down menu.
3. 3.Enter the unique identifiers from your Step 2 ministry letter.
4. 4.Review and accept the Acceptable Use Policy for Electronic Business Services.
5. 5.You should see "Successful Enrolment".
6. 6.Log out and close your browser.
7. 7.Reopen your browser and sign in at ebse.health.gov.on.ca to confirm access.

From the Administration and MOHLTC Services screen you can submit claim files, run remittance advice inquiries, respond to additional information requests, and authorize designees.

Submission cutoff. OHIP processes claims monthly. Submissions received after 5:00 pm on the 18th of a month may not be approved until the next processing cycle. Example: November 18 submission appears on the December Remittance Advice; November 19 submission may not appear until January. Plan your billing cadence around the 18th.

How MedConcierge handles submission

MedConcierge acts as your billing agent under the Personal Health Information Protection Act. You remain the Health Information Custodian; we act as your agent, especially for full-service billing.

Most billing services require you to complete the Designee Maintenance process inside OPS BPS Secure, which is a multi-step setup that requires the designee to accept the authorization back through their own login. MedConcierge bypasses this entirely. You provide your MCEDT credentials inside the MedConcierge app, and we upload claim files and download remittance advice files on your schedule. No designee paperwork. We however still recommend adding us as a designee in the MCEDT portal in order to allow more flexibility for us to help you with any issues with claims.

If you prefer to manage claim submission yourself through your own OPS BPS Secure login, that is also supported in the self-billing tier.

Step 5: Register with Medavie Blue Cross

OHIP does not cover patients on federal health programs. If you work in an ED, walk-in clinic, or any acute care setting, you will see these patients. To be paid, you must be registered with Medavie Blue Cross.

Programs administered by Medavie Blue Cross

• Interim Federal Health Program (IFHP): refugees and protected persons
• Canadian Armed Forces (CAF): active and reserve military members
• Royal Canadian Mounted Police (RCMP)
• Veterans Affairs Canada (VAC)

Registration steps

1. 1.Go to medaviebc.ca/en/health-professionals/register.
2. 2.Select "I don't have a provider ID and I'd like to register".
3. 3.Complete the Provider Registration form with your credentials, practice address, and CPSO number.
4. 4.Read and accept the Terms and Conditions.
5. 5.Submit. You will receive a Medavie Blue Cross provider number and ePay access once approved.

Alternative: call 1-888-614-1880, Monday to Friday, 6:00 am to 9:00 pm Eastern.

IFHP-specific IRCC reference: canada.ca/en/immigration-refugees-citizenship/services/refugees/help-within-canada/health-care/professionals.html

Claim submission window: six months from date of service (longer for some program subtypes). Build this into your workflow.

IFHP activation lag. Coverage takes at least two business days to activate in the Medavie system after it is issued. Beneficiaries are still eligible during that window. If a refugee patient's coverage is not yet showing in the portal, see the IFHP Information Handbook for Health Care Professionals for claim handling.

Step 6: Register with WSIB

The Workplace Safety and Insurance Board pays for care related to workplace injuries and illnesses. ED, walk-in, occupational medicine, and most acute care physicians will see WSIB patients. Physicians register through TELUS Health, which operates WSIB eServices on behalf of the WSIB.

Registration steps

1. 1.Go to the WSIB physicians hub: wsib.ca/en/physicians.
2. 2.Follow the link to register for electronic billing through TELUS Health.
3. 3.Complete the TELUS Health registration with your CPSO number, practice address, and banking details.
4. 4.Submit. You will be assigned a WSIB provider number and set up for electronic submission.

Alternative: call TELUS Health Solutions at 1-866-240-7492.

What to know: WSIB requires its own forms: Form 8 for the initial report is the one you will complete most often. Submitting electronically pays a higher fee and faster than paper submission. WSIB claims in Ontario are submitted in the same process of regular claim submissions, with the only requirement of selecting WSIB as the payment program.

Step 7: Quebec patients and RAMQ

Quebec does not participate in the reciprocal medical billing agreement that covers other provinces. OHIP will not recover payment from RAMQ on your behalf. If a Quebec resident presents to your ED, walk-in, or clinic, you have three options.

Option 1: Bill the patient directly

Collect payment from the patient at the point of care. The patient then applies to RAMQ for reimbursement using their own claim. RAMQ's reimbursement page for patients: ramq.gouv.qc.ca/en/citizens/health-insurance/reimbursement-covered-services.

RAMQ reimburses up to Quebec rates, regardless of what you charged. The patient absorbs any difference.

Option 2: Register as a RAMQ out-of-province provider

You can register directly with RAMQ as a health professional outside Quebec. RAMQ then pays you directly at Quebec rates, and you do not collect from the patient. The forms can be completed in French or English, and registration takes 4 to 8 weeks. MedConcierge will offer a guided RAMQ registration workflow in a future release.

Option 3: Bill RAMQ directly using Form 4292

The middle path for physicians who see Quebec patients only occasionally. You do not register with RAMQ and you do not collect from the patient. Instead, you complete RAMQ Form 4292 (the English version of Form 2688, "Out-of-Province Claim for Physician Services"), mail it in, and RAMQ pays you directly at Quebec rates. Form: ramq.gouv.qc.ca/sitecollectiondocuments/professionnels/formulaires/4292.pdf.

Form 4292 is a single page that you complete in full; the patient does not sign. You may enter either the OHIP fee code you would have used or the equivalent RAMQ act code. It is paper-mail only (no email, fax, or upload), and you have one year from the date of service to submit. Payment typically arrives in 4 to 12 weeks. Keep a copy of everything you mail. For the full walkthrough, see the MedConcierge RAMQ registration guide (Option C).

RAMQ contact: 1-800-561-9749.

Step 8: UHIP (international university students)

UHIP — the University Health Insurance Plan — covers international students, visiting faculty, and their dependents at Ontario universities. It is not OHIP: it is administered privately by Cowan Insurance Group and pays physician services at up to 125 percent of the OHIP rate. If you work near a campus, in a walk-in clinic, or in an ED, you will see UHIP members, so it is worth being set up to bill them.

Three ways to get paid

• Join the Preferred Provider Network (PPN). Email Cowan at uhip@cowangroup.ca to apply. Once enrolled you bill Cowan directly and your clinic is listed in the UHIP directory. Best if you see UHIP members regularly.
• Direct-bill per encounter. For occasional encounters, submit the claim through the Cowan provider portal without joining the PPN.
• Have the patient pay and claim. The member pays you at the time of service and submits to Cowan for reimbursement.

For the full walkthrough — eligibility, the PPN application, and how the 125 percent rate is applied — see the MedConcierge UHIP guide.

Setup checklist

Approximate timelines. Actual processing times vary during peak onboarding periods (June, July, August).

Choosing a claim submission method

Registration alone does not submit claims. You need a submission method. Three options exist:

Direct MCEDT submission

Submit claims yourself by uploading ministry-format claim files through your OPS BPS Secure account. Requires building or buying software that produces the correct file format. Not recommended unless you have technical resources to maintain it.

Self-billing platform

A software platform prepares and submits claims on your behalf. You enter the patient encounter and fee codes; the platform handles the file format, submission timing, error reconciliation, and remittance matching. You retain control and oversight.

Full-service billing

A billing service performs data entry, coding review, submission, and claim follow-up on your behalf. You provide encounter information (shift lists, procedure notes, or chart access); they handle everything else. Highest convenience, highest cost.

MedConcierge pricing. Self-billing: 0.25% of paid claims, capped at approximately $40 per month. No setup fees.

Workflow recommendations

Two practices will save you the most money and time in your first year.

Bill the same day

Enter your claims immediately at the end of a day, while patient details are fresh. Batch-entering a week of claims increases errors, missed codes, and missed premiums. A five-minute end of day habit is worth hundreds of dollars over a year.

Reconcile every Remittance Advice

The ministry releases a Remittance Advice around the 20th of each month. Review it: rejected claims can often be resubmitted, and systematic rejections (wrong specialty code, wrong health card version, expired diagnosis code) will recur until the root cause is fixed. Do not skip this step.