Error report · Eligibility & health card
OHIP error code EPS
Patient Not Eligible for Program
What EPS means
The Ministry of Health’s official wording for EPS is: “Patient Not Eligible for Program.”
This code appears on your Claims Error Report (downloaded through MCEDT). It means the claim was rejected at submission and was never adjudicated for payment — fix the issue below and resubmit the claim.
How to fix EPS
The patient isn't eligible for this program - confirm their eligibility; bill the correct payer if they aren't covered.
Eligibility and health card codes relate to the patient's health number, version code, or OHIP eligibility on the date of service. Most are fixed by re-checking the card (or using Health Card Validation) and correcting the patient details before resubmitting.
Related codes
- EP1Enrolment Transaction Not Allowed
- EP2Not for Enrolment/ReEnrolment
- EP3Incorrect Service Date – Check Date of Enrolment
- EP4Enrolment Restriction Applied
- EPANetwork billing not approved
- EPCPatient not rostered/rostered to another Network
- EPFEnrolment Date Mismatch
- EPPIncorrect Code for Eligibility (Ontario Works/Ontario Disability Support Program)
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Code meaning per Ontario Ministry of Health — Error Report Rejection Conditions / Error Codes (December 2022). The suggested action is general information for Ontario physicians, not billing, legal, or tax advice — codes and rules change, so verify against the current Ministry of Health documents before relying on a claim.