OHIP Solo vs Group Account Billing – what does it mean?
- 2 min read
What are Solo and Group accounts?
Solo account and Group account are the terms used to describe how claims are submitted to the Ontario Ministry of Health for payment.
Solo Account
Once a physician has received their 6-digit OHIP billing provider number, they are automatically set up with a solo account – 0000. Using billing software, they may submit claims directly to OHIP using the solo number and their billing provider number. Claims will be paid directly to the bank account associated with the physician’s Solo account. Approved, denied and partially denied claims will appear on their Solo Remittance Advice, which the provider may access through OPS BPS Secure (formerly GoSecure).
Additionally, from time to time, there may be payments or deductions applied by the Ministry of Health which most often occurs in the provider’s Solo account. An example of this is a retroactive payment related to the Physician Service Agreement (PSA). Therefore, it is important the Ministry has up-to-date banking information.
Group Account
A group is a 4-character number the Ministry issues that allows individual physicians to have their billings associated with a group. Billing group numbers are assigned by the Ministry in accordance with the type of group. For example, a group beginning with A is associated with a fully converted AFP. For claims to be accepted and paid to a physician, they must submit an OHIP Group Registration for Health Care Professionals form. When claims are submitted to the Ministry, they must include the billing group and the individual billing provider number. Approved, denied and partially denied claims will appear on the Group Remittance Advice.
At RMA, with over 40 years of experience, we are experts in managing Group Accounts and their rules. We are setup to deal with the administrative complexity, so that physicians don’t have to. Our staff is always happy to help!
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