Overview
Remittance Advices (RAs) are payment notifications from the Ministry of Health detailing which claims were paid, partially paid, or rejected.
Accessing Remittance Advices
Navigate to Reports > Remittance Advices in the sidebar.
Understanding Remittance Advices
Each remittance advice contains:
- RA Number - Unique identifier
- Payment Date - When payment was issued
- Total Amount - Sum of all payments
- Claim Count - Number of claims processed
Viewing RA Details
Click on a remittance advice to see:
Summary
- Total paid amount
- Number of claims paid in full
- Number of claims partially paid
- Number of claims rejected
Claim Breakdown
Each claim in the RA shows:
| Field | Description |
|---|
| Patient | Patient name and health card |
| Service Date | Date of service |
| Billing Code | Service code billed |
| Billed Amount | What you claimed |
| Paid Amount | What was paid |
| Explanation Code | Reason for adjustment (if any) |
Explanation Codes
When a claim is adjusted or rejected, an explanation code indicates why:
| Code | Meaning |
|---|
| V1 | Health card not valid on service date |
| R1 | Patient not eligible |
| P1 | Service already paid |
| … | See full list in OHIP documentation |
Click on an explanation code to see the full description and recommended action.
Filtering and Search
- Filter by date range
- Search by patient name or health card
- Filter by payment status (paid, partial, rejected)
Reconciliation
The RA view helps with reconciliation:
- Compare billed vs. paid amounts
- Identify rejected claims for resubmission
- Track partial payments
Actions
From an RA detail page, you can:
- Export to Excel - Download for accounting
- Print - Generate a printable version
- Resubmit Rejected - Create corrected claims for rejected items
Notifications
Configure notifications in Settings to receive alerts when new remittance advices are available.