Stale Dated OHIP Claims
- 2 min read
What is a Stale Dated claim?
Effective April 1st, 2023, the Ministry of Health (MOH) changed their stale date period from 6 months to 3 months. Claims submitted to the Ministry past the 3-month period, will reject on the Error Report with error code VJ7 “Stale dated Claim”. These claims will not be accepted by the Ministry unless there are extenuating circumstances or if the claim was previously submitted within the 3-month period, subsequently rejected on the Error Report, corrected and resubmitted after the 3-month period.
How to prevent claims from stale dating?
With the shorter deadline of claims submission to the Ministry, it is best practice to submit billing as soon as possible after the service was provided, as it will allow RMA to process your claims to the MoH well before the 3-month period. This will not only prevent your claims from stale dating but will also provide our team sufficient time to investigate, correct and resubmit any claims on the Error Report. Claims submitted to the MoH on time but rejected on the Error Report will be accepted once corrected and resubmitted, however these claims must follow a different process set out by the MoH to ensure they are accepted.
Are you an RMA physician? You can reach out to your Billing Advisor representative, and they can help you with any further questions or provide assistance.
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