Registration and Starting a Medical Practice
Ultimate Guide to Medical Billing for New Doctors
There are many things you need to do after passing your exam, and before starting a medical practice in Canada. There are some dependencies, so below, we’ve created a new medical practice checklist to tackle the requirements for registration in a logical order.
- Apply for Your Independent Practice License in Ontario (CPSO)
- Update CMPA Membership to Reflect Independent Practice
- Applying for Hospital Privileges
- Get an OHIP Billing Number
- Update Your Primary Practice Address
- First-time Set-up of Go Secure/ Medical Claims Electronic Data Transfer (MCEDT)
1. Apply for Your Independent Practice License in Ontario (CPSO)
As an Ontario physician-in-training or resident, you already have a restricted license from the College of Physicians and Surgeons of Ontario (CPSO). To legally practise as an independent physician, you need to be fully licensed from this body.
Once you write the licensing exam and pass, you can apply to CPSO for your “independent practice license.” Essentially this is a 5-digit number that enables you to work independently, diagnose and treat patients, write prescriptions, etc. Having this license also allows you to get an OHIP billing number (see below).
- Apply for your independent practice registration through physiciansapply.ca.
- Before you start, read these guidelines from the CPSO.
- Learn more about the licensing process from the CPSO.
2. Update CMPA Membership To Reflect Independent Practice
As a resident, you already subscribe to CMPA-the Canadian Medical Protective Association. As you know, this is the malpractice insurance for which all physicians must sign up when starting a medical practice. Once you get your independent practice license and have both a job and a work address, your options are to:
- Transition To Practice: When you plan to transition from your postgraduate program to practice, you can find more information on updating your CMPA membership to reflect your new status: changing from TOW 12 to an independent license. The CMPA also offers the option to defer payment of membership fees for up to 6 months; learn more here.
- Moonlight: If you plan to independently practice outside of your residency or structured fellowship program (whether you are remunerated or not) this is considered moonlighting. More information from the CMPA on changing to TOW code 14.
- Update your medical liability protection with the CMPA here.
- Learn more about CMPA membership fees here.
3. Apply For Hospital Privileges
Hospital privileges give physicians the authority to perform specific patient care in a specified healthcare facility. They also specify the types of procedures a physician may perform in the hospital. The process for granting, changing and terminating hospital privileges are set out in a hospital’s by-laws.
Privileges are granted to physicians based on their current medical credentials and previous performance.
You will need to contact your hospital department that is hiring you for details in obtaining your privileges.
4. Get An OHIP Billing Number
It’s important to note that you’ll need both a CPSO number and an OHIP billing number to submit claims for reimbursement. Getting your OHIP billing number typically takes anywhere from 4-6 weeks, and you’ll need your CPSO number before you get started.
- Follow our step-by-step OHIP billing number process to register with the Ministry of Health and Long-Term Care and get your billing number.
- While you wait for your OHIP billing number, you can work and practice billing, but you won’t be able to submit your claims until you have completed all the steps in this chapter.
5. Update Your Primary Practice Address
Under the Ontario Health Insurance Act, all physicians are required to notify the Ministry for every place of practice. When setting up a practice, you need to identify primary, secondary and other practice addresses, including when those dates became effective.
As a newly licensed physician, keep in mind: Your billing number may be suspended should the Ministry try to send you mail, but it is returned to them.
- Follow our step-by-step instructions to change your practice address and mail locations.
6. First-time Set-up of Go Secure / Medical Claims Electronic Data Transfer (MCEDT)
Once you have your OHIP billing number, it’s time to set up your Go Secure account. MCEDT is the secure system Ontario uses to access Ontario Public Services online, and it’s where you will have access to the Medical Claims Electronic Data Transfer system that allows you to share data with the Ministry.
Keep in mind: You cannot bill in Ontario without setting up your Go Secure / MCEDT account.
- Step 1: You should have received a package to set up your Go Secure account when you obtained your billing number. The instructions will guide you to create a login and password, and enter “unique identifiers” sent to you by mail.
Note: If you do not have this package, you will need to contact the EDT help desk to re-issue you the instructions with the “unique identifiers”. The EDT help desk can be reached at 1-800-262-6524 (option 4 – 1) or, [email protected].
- Step 2: Follow our step-by-step process for setting up your Go Secure/MCEDT account with MDBilling.ca.
Before moving on to the next chapter, here is a checklist to help you complete your registration and medical practice set up. Click or tap the image to download the printable PDF.