Ontario
OHIP billing staff for Ontario physicians
OHIP billing staff from OffshoreMeds work for Ontario physicians as designated agents. All OHIP claims must be submitted through MCEDT, and the Ministry of Health lets physicians designate administrative staff or third-party agents to act on their behalf. Under Ontario’s PHIPA, providing health information to an agent is a use by the physician, not a disclosure. One flat monthly fee per seat, never a percentage of collections. This is general information, not legal advice. Review your payer contracts and the rules where you practice with your compliance advisor.
Published by OffshoreMeds. Facts last checked October 9, 2026. How we check our numbers.
Claims
How OHIP billing staff fit into MCEDT
The Ontario Ministry of Health says all claims must be submitted through medical claims electronic data transfer (MCEDT), and that physicians can designate access to administrative staff, third-party agents or other providers to act on their behalf. Our staff work as that kind of designated agent, under your account.
- Prepare and submit claim files through your MCEDT designation.
- Download and reconcile the reports that come back, and follow up on rejected claims.
- Work in your billing software, under your access controls.
- We confirm each candidate’s experience with OHIP claiming before you interview them.
Two Ministry documents shape the setup. A Registered Third Party Billing Agency applies for its own group number to submit claims, and must provide proof of an Ontario business address, among other requirements (OHIP billing number registration). Whichever structure you choose, the Ministry tells physicians they are responsible for all claims submitted and for reconciling all payments made under their billing number, regardless of who submits the claim or receives the payment (INFOBulletin 4656).
Privacy law
What PHIPA and PIPEDA say about offshore agents
| Rule | What it says | Source |
|---|---|---|
| Rule: PHIPA s. 6(1) | What it says: Providing personal health information between a custodian and its agent is a use by the custodian, not a disclosure. | Source: PHIPA, Ontario e-Laws |
| Rule: PHIPA s. 17(1) | What it says: The custodian stays responsible for the information and may let agents handle it on its behalf only under the conditions the Act sets. | Source: PHIPA, Ontario e-Laws |
| Rule: PHIPA s. 50(1) | What it says: Disclosing personal health information collected in Ontario to a person outside Ontario is allowed only in the listed cases. | Source: PHIPA, Ontario e-Laws |
| Rule: PIPEDA | What it says: Transferring personal information to another jurisdiction for processing is not prohibited; it is a use, and the transferring organization stays accountable, mainly through the contract. | Source: Privacy Commissioner of Canada |
Three things to confirm before go-live:
- Your privacy advisor agrees the arrangement is an agent relationship under PHIPA, with an agent agreement that sets the conditions in section 17.
- Which structure applies: staff designated as agents under your own billing number, or a registered third party billing agency with its own group number. The second needs an Ontario business address, so confirm it with the Ministry before you sign.
- Written confirmation from the Ministry that your MCEDT designation can be used by staff working outside Canada. We could not confirm this from the Ministry’s public pages, so get it before anyone logs in.
Scope
Other provinces
This page covers Ontario. Other provinces have their own health privacy laws. In Quebec, for example, a business must carry out a privacy impact assessment before it entrusts personal information to anyone outside Quebec (Commission d’accès à l’information). This is general information, not legal advice. Review your payer contracts and the rules where you practice with your compliance advisor.
Cost
What an OHIP billing seat costs
A seat costs $1,500 to $2,000 per month, quoted in US dollars. Prices are indicative until your written quote confirms the exact fee. For comparison, Job Bank puts the median wage for a medical administrative assistant in Ontario at CAD 25.00 an hour (2023-2024). The offshore medical billing cost page explains how to compare a seat with an in-house hire, and how to outsource medical billing sets out the steps. Clinics in the UK can read about UK private practice billing staff.
The terms behind each seat
One flat monthly fee per seat, never a percentage of collections. A Business Associate Agreement is signed before anyone touches protected health information. Clinical decisions stay with your US-licensed providers. See all OffshoreMeds services.
Related guides
- Offshore medical billing cost
Seat fee, US in-house cost and percentage-of-collections fees side by side, with the method shown.
- UK private practice billing staff
Insurer invoicing with CCSD codes through Healthcode, and the UK GDPR documents an offshore team needs.
- How to outsource medical billing
Five steps from choosing roles to go-live, with the compliance and cost checks in the right order.
- Business associate agreement for offshore billing
The terms HIPAA requires in the contract, what the practice must do about problems, and what to add for offshore work.
- OHIP stale-dated claims and error reports
The Ministry's three-month rule, the reports after each submission, the monthly cut-off and how to work rejected claims.
- Data privacy by country
No general ban in six places, the contract each expects, the UK and EU transfer rules, Australia's disclosure approach and one narrow ban.
Get Started
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Please keep patient information out of the booking notes. A Business Associate Agreement is signed before anyone touches protected health information. See how this site handles your details in the privacy policy.