Advanced OHIP Billing & Rejection Code Training

Master rejection codes, K-codes, and claim corrections with an Ontario OHIP billing expert.

Instructor: Jackie Allen, Ontario Health Insurance Plan (OHIP) Billing Specialist

Next Start Date: January 12, 2026 – register now to hold your spot

Live Classes: Mondays, 7:00–8:00 p.m.  (EST)

Duration: 4 weeks 

Committment: Students typically complete the Advanced OHIP Billing Certificate in 12–18 hours including live instruction, assignments, and case-scenario practice

Price: $295

Enrollment: Limited spots available

What You Will Learn (Modules / Key Skills)

1. Billing Combinations & Optimization (Compliant Fee Pairing)

Learners explore which services are eligible to be billed together under OHIP rules, and which combinations are restricted, with a focus on compliant, accurate billing.

Examples covered:

When counselling codes can be billed with core visit codes

When special visit premiums apply

Time-based mental health increments

Eligible vs. ineligible combinations

Scenario-driven decision-making

Purpose: ensure participants understand correct claim combinations and revenue maximization.

2. WSIB Billing

Training includes:

WSIB form billing

Program of Care (POC) billing rules

Mandatory fields & timelines

Common rejections and how to avoid them

Understanding billing obligations

3. Rejection Codes & Resubmissions

Learners practice:

Interpreting OHIP rejection messages

Identifying the root cause (diagnostic mismatch, service date, eligibility issues, etc.)

Correcting and resubmitting claims

Preventing repeat errors

4. Billing Increments

Covers eligible increments for:

Mental health counselling

Extended visits

Palliative or home visits

Special visit premiums

After-hours premiums

Time-based documentation requirements

5. Scenario-Based Billing Using Realistic Mock Cases

Learners apply their knowledge using full-case scenarios representing real Ontario practice conditions:

Multi-issue encounters

Mental health sessions

Chronic disease follow-up

Walk-in vs. family practice scenarios

After-hours and weekend visits

WSIB cases

Correcting rejection messages

Each scenario guides learners to:

Interpret the encounter

Determine billable services

Apply correct fee codes & modifiers

Submit claims

Correct any rejections

Who This Course is For

Medical Office Assistants

Physician billing staff/billers

Clinic managers

College instructors

College students

Physicians

Course Outcomes / Employer Benefits

Become an even more valuable employee

Higher billing accuracy

Fewer rejected claims

Better oversight of billing performance

One corrected billing error can pay for the course

Clinics commonly lose $5,000+ annually from avoidable billing mistakes

Course Format (Weekly Breakdown)

Week 1 – OHIP fundamentals, coding, increments

Week 2 – WSIB billing + insurer changes

Week 3 – Rejections + resubmissions

Week 4 – Case billing + student submitted scenarios

Weekly 1-hour Q&A session

Quiz – Learners must achieve 80% or higher to receive a certificate. Includes one complimentary retake.

Technology Used

Moodle for assessment, course materials, and certificate

Zoom for weekly live sessions

Pricing

Price: $295 / enrollee 

All learning materials will be provided. No textbooks are required.

Volume pricing available for clinics (3+ enrollments)