Medical Billing (OHIP)

Course Outline  |   Apply Now

Students will learn how to apply the basic principles of Health Claim billing as outlined in the MOH (Ontario) "Schedule of Benefits" to complete health claims and the reconciliation of accounts. The student will learn to input Health Number billing on a computerized system.


Prerequisite: None
Hours / Duration: 38 hours/8 weeks maximum

Cost: $399 (Includes Text and Student Guide)

Learning Objective

By the end of this course, students should understand the following:
  • How the Ministry of Health (MOH) operates
  • How health claims are processed from patient encounter to receipt of payment
  • The relevant materials and reference information available when preparing and reconciling claims
  • The basic information that is required to complete a patient claim to the MOH
  • The meaning of the MOH codes, prefixes, and suffixes
  • The difference between calls/visits, test/procedures and surgical procedures and how to locate each in the Schedule of Benefits
  • How to locate diagnosis codes on the diagnosis code list
  • How to prepare billing sheets for patient claims, which are typical of a Family Practice
  • How to complete billing sheets typical of a General Surgeon
  • How to prepare claims for procedures and services using evening and night rates
  • The methods of making the process of HCP billing and reconciliation as efficient as possible
  • How to design an efficient billing and reconciliation system for their particular office environment
  • The process of billing a third party

Course Schedule

Weeks 1
  • Unit 1: Introduction to the Ministry of Health Insurance Plan
Weeks 2-3
  • Unit 2: Preparing patient claims and understanding health cards
  • Unit 3: Understanding the MOH Schedule of Benefits and Diagnostic Codes
Weeks 4-5
  • Unit 4: Learning to bill for a family or general practice
  • Unit 5: Learning about family health networks and groups
  • Unit 6: Learning to bill for medical specialists
  • Unit 7: Learning to bill for a general surgeon
Week 6
  • Unit 8: Understanding account reconciliation
  • Unit 9: RMB and WSIB billing
Week 7
  • Unit 10: Efficient strategies for billing
Week 8
  • Final Assessment

Additional Notes

Assessment: Billing assignments, quizzes, discussion board participation
Learning Materials: Easy steps to efficient medical billing, student manual, Eberhard & Symonds (medcom Solutions); Quick Claim  (PC based software)

 *This program does not require approval under the Private Career College Act, 2005