Eligible Services

Overview of Eligible Services:
As a billing service provider, we have a comprehensive understanding of these services, ensuring that all billable activities are accurately captured and appropriately filed. The scope of eligible services is defined by the Ontario Ministry of Health, reviewing the schedule of benefits to reflect evolving healthcare practices and policies.

Billing Compliance and Specifics:

We are well-versed in the specifics of each service category and the corresponding billing codes. This expertise is vital not only for maximizing reimbursement but also for maintaining compliance with OHIP regulations. Understanding the nuances of these criteria, including exclusions and special circumstances like out-of-province, is a key part of the billing process. We work with you to ensure accurate documentation and adherence to the latest billing guidelines; this is how we ensure you are paid in a timely manner for the services rendered you as the physician.

Ask us how we can help you save and capture your billables effectively. Over 600 physicians use our service, join us in our ever-growing list of clinicians.

Physician Billing Codes

The codes are part of a comprehensive schedule maintained by the Ontario Ministry of Health, which categorizes every conceivable medical procedure and consultation that a physician might provide. These codes not only specify the nature of the service but also indicate the complexity and time required for each procedure, forming the basis for the billing amount.

Physicians often face challenges in selecting the most appropriate billing codes due to the complexity and specificity of the services rendered. Misinterpretation of a code can result in underbilling or overbilling. Regular training and updates with AMMC for physicians are essential to mitigate these challenges.

We have comprehensive methodology in helping you understand the complexities of OHIP Billing, ask us any questions or concerns you may have about a claim, we can help you hit the submit button within matter of minutes.

Claims Submission

Integration with Various EMRs:
Effective claims submission starts with integrating your billing process seamlessly with these various EMRs. This involves understanding the data export capabilities of each EMR and ensuring that your billing software can accurately interpret and process this data.

Consistency in data entry across different EMRs is crucial. Training for physicians and staff on accurate and consistent data entry will help in reducing errors during the claim’s submission process.

Effective Batch Submission:
Before submitting a batch, ensure that all claims within the batch are complete and accurate. Use pre-submission verification tools or checks to identify and correct any errors or inconsistencies.

After submission, track the claims through their processing lifecycle. Quick follow-ups on rejected or denied claims are essential for rectifying errors and resubmitting.

Audit and Compliance

We utilize advanced analytics through our analytics dashboard application that can integrate with multiple EMRs, optimizes error checking, and provides data driven reports for improving the claims process.

We help review our client’s rejections and audit their billing processes to ensure that our clients are meeting the ministries guidelines. Our auditing processes and rejections reviews have helped client’s save up-to $50,000 in monthly billables.

Want our help in ensuring your claims, patient information, and billing processes are done properly, reach out to us today.

Patient Eligibility Verification

At AMMC, we simplify healthcare billing and patient eligibility verification for you. Our experienced team excels in managing both Private Insurance and OHIP-covered services with unmatched precision. We ensure accurate billing using the correct codes and verify insurance eligibility, effectively reducing administrative hassle and enhancing claim reimbursement. When navigating the complexities of insurance policies and OHIP guidelines, let AMMC be your trusted partner for streamlined billing processes and eligibility checks, ensuring a smooth and efficient healthcare experience.

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