Choosing the Right OHIP Billing Software for Your Practice

Chapter 3

Choosing the Right OHIP Billing Software for Your Practice

Ultimate Guide to Medical Billing for New Doctors in Ontario

The next step is choosing the right OHIP billing software

You are likely new to this and–unless you have tackled medical billing for a family member or friend–may have a few questions: What should I consider when choosing billing software? How can medical billing software assist with the billing process? What is the best medical billing software to use? Should I go with a full-serve or a self-service plan? How can I evaluate if the software is dependable? In this chapter, we’ll answer these questions.

How to Choose the Right Medical Billing Software for Your Practice

No matter which vendor you choose to work with (as we covered in chapter 1 – registration and starting a medical practice you should always seek medical billing software that:

  • Is mobile and web integrated 
  • Has the ability to designate sub-users
  • Has a proven track record
  • Offers a range of service options
  • Adheres to privacy and security measures (MOHLTC-conformance tested)
  • Offers EMR integrations

What To Expect from

Mobile and Web Integrated

Locums, moonlighting, or working at multiple hospitals? Travelling for business or pleasure? enables you to access your data while on the go. All you need is a web browser and an internet connection. 

Learn more about our mobile billing app

Ability To Designate Sub-users offers the unique ability to partition access to the medical billing software to different types of users, whether your accountant, your bookkeeper, your assistant or office administrator. 

This ensures that with each team member, you only share the required information for each task. This feature makes it easy for you to delegate billing (or any accounting or bookkeeping responsibilities) without compromising confidentiality if you are busy working with patients. 

Learn more about managing sub-users.

Range Of Service Options: Self-service, Ad-hoc Billing Assistance, and Full-service

When you start your practice, it’s hard to anticipate if you’re going to have time to (or are interested in!) submitting billings yourself. Some doctors opt to delegate this to a family or friend or outsource billing to one of our experienced agents. 

In any case, we offer 2 different options.

  1. Self-service: Software only
  • Pricing: 0.25% of paid claims. Capped at $600 per year.
  • Online access – browser or mobile app
  • Payment and Reconciliation reports
  • Shows warnings based on the OHIP Schedule of Benefits
  • Access to “do-it-yourself” knowledge base

Ad-hoc Billing Assistance for Self-service (optional)

  • Pricing: $50/hour
  • Hourly consultative services for difficult billing situations such as appeals, reconciliation, or non-OHIP claims.
  1. Full-service: Billing Agent Services
  • Pricing: 2.0% of paid claims
  • Online access – browser or mobile app
  • Payment and Reconciliation reports
  • Proactively fix claims based on the OHIP Schedule of Benefits
  • Personalized service – assigned billing staff
  • Contact hospitals or patients for missing information
  • Resubmission of rejected claims
  • Submit non-OHIP claims
  • Detailed monthly payment reconciliation and resubmission of claims
  • Paper submissions: +0.5% extra for high accuracy data entry 

Learn more about the cost of medical billing.

Which Billing Option is Right for You? 

If you’re on the fence about which option might be best for you, consider the following questions:

Ask yourself:Keep in mind:Score:
Are you new to billing?If you have done shadow billing before, you may have a working familiarity with the process and will pick it up quickly. At, we have over ten years with OHIP billing. This means that our experienced billing agents have seen it all, and can save you time learning how to bill. Yes=1
Do you have complicated billing?Admittedly, Ontario’s billing guidelines are known to be the most complicated in Canada At, we have focused expertise in specialist billing, internal medicine & subspecialities, and surgical specialities. Yes=1
Do you have the time to learn how to bill and to continue billing on an ongoing basis?Remember, your time is money. Here’s an easy equation to calculate your hourly rate:

Annual income / Weeks worked per year / Hours average work week = Your $/hour.

For example, $340,000 / 40 weeks / 40 hours = $212.50 per hour.
As a highly paid professional, it may be worth your time to focus on your core responsibilities and outsource billing to our experienced agents.Yes=0
Are you interested in learning how to do your own billing?Even if it makes more financial sense to outsource, if you get satisfaction out of learning the ins and outs of billing, there is no reason why you can’t do it yourself. offers tons of free DIY billing support resources to help you along the way.

Check out our training videos on how to bill OHIP
Learn more in our OHIP billing knowledge base.
Do you have colleagues that can ask questions about billing?It can be beneficial to have a work buddy who does similar work and can help you with any questions about service codes. If you choose to rely on your colleagues’ recommendations, just remember: There are a few ways to bill correctly, but an infinite number of ways to bill incorrectly!

When in doubt, refer to our DIY billing support resources, or consider consulting us on an ad-hoc basis for coaching.
Do you have a trusted family member or friend who can help you fix rejections and reconcile?Billing through is easy, but fixing rejections can be time-consuming.

When selecting a billing assistant, be sure to think beyond good intentions, and consider whether this individual has the experience or expertise to help you. makes it easy to designate sub-users–which means that you can create separate profiles for your billing assistant and other team members.

And if your billing assistant gets stuck with a tricky rejection to fix, they can rely on our ad-hoc services to help coach them through it.

Add up your score

Answered Yes more than 3 times? Outsource billing to an experienced billing agent.
Answered Yes 3 or fewer times? Tackle billing yourself and refer to our DIY billing support resources for guidance.  Consider hiring us ad-hoc at an hourly rate, when needed.

Proven Track Record: 10 Years in Business And Robust Client Base 

We’ve been in business for 10 years and with a 23-person team (and growing), we are the largest OHIP medical billing software company in Canada. Over the years, we’ve served many hospital groups, including: Lakeridge Health, Hamilton Health Sciences, Toronto General, North York General, Sunnybrook Health Sciences Centre, and many more.

  • Over 7,000 physicians use MDBilling.caTM
  • Over $2.1B in OHIP claims paid through since 2008
  • Over 85% of our clients recommend us

I love how easy it is to attach a premium code to one or multiple parent service codes using your interface. It is also easy to input diagnostic codes by just typing in the diagnoses and the system offers relevant diagnostic codes.

– Dr. Y. Kirkham, Obstetrics & Gynaecology, St. Joseph’s Health Centre.

Privacy and Security Measures (MOHLTC-Conformance Tested)

Our software has been tested and meets the rigorous standards set by the Ministry of Health & Long Term Care, to ensure reliability. We have performed both a third-party privacy impact assessment (PIA) and threat-risk assessment (TRA).  When you choose to work with us, data security is just one more thing you don’t have to worry about. Our servers and your data are housed in a secure Canadian data centre and we use 256-bit SSL encryption and software security to ensure your data remains safe. Learn more about our privacy and security commitment.

EMR Integration

If you do need to integrate billing software with an existing EMR application, you can let your software developer know that we have an API integration. This allows you to realize the benefits of an EMR, while using to help you get paid faster, and maximize your revenue. 

Our pre-built integration with the OSCAR EMR allows for patient data entered into OSCAR to be transferred directly into for a fully integrated system. Learn more about our developer API.