OHIP Documentation Requirements

OHIP and Ministry of Health and Long-Term Care
(MOHLTC) requirements may change over time and
physicians should stay abreast of any changes through
OHIP and Ontario Medical Association (OMA)
information sources.
Physicians must understand their obligations under
the Health Insurance Act and the OHIP Schedule of
Benefits. Section 37.1 of the Health Insurance Act,
which deals with record keeping, is attached as
Appendix C.
Good records demonstrate that a service was provided
to the patient and establish that the service provided
was medically necessary. It is, therefore, imperative
that physicians maintain accurate and comprehensive
records, in order to receive payment for their services.
Any questions that physicians may have regarding the
OHIP Schedule of Benefits should be directed to the
appropriate local branch of OHIP or the Provider
Services Branch of the MOHLTC.