Bulletin 230303 — New eSubmit file type for Ministry responses and requests in MCEDT
New eSubmit file type under "Available Reports" to download in MCEDT for Additional Information Requests and Remittance Advice Inquiry Reponses
To: OHIP Billing Software Vendors, Physicians, Primary Care Physicians, Hospitals, Independent Health Facilities, Hospital-based Dentists, Optometrists, Podiatrists, Physiotherapy Facilities, Fertility Clinics
Categories: Billing Software Specifications, Physician Services, Primary Health Care Services, Independent Health Facilities, Dentist Services, Optometrist Services, Podiatrist Services, Physiotherapy Facilities, Fertility Clinics
Written by: Claims Services Branch; Health Programs and Delivery Division
Date issued: March 13, 2023
Background
eSubmit is a secure electronic channel for health service providers to submit Remittance Advice Inquiries (RAIs) and medical claims supporting documentation (operative reports and clinical notes for manual review) which supports the adjudication of claims, as outlined in INFOBulletin #221201-eSubmit Service Delivery Enhancements.
All authorized Medical Claims Electronic Data Transfer (MCEDT) users, including designees, automatically have access to the eSubmit service. Access eSubmit through GO Secure via www.ontario.ca/eSubmit.
New file type for eSubmit communications
Effective March 13, 2023, the new file type EFR and subject eSubmit Form Return will be displayed in MCEDT when receiving Additional Information Requests (AIRs) or RAI responses.
To download the new file type, designees will need to be granted MCEDT permissions for eSubmit Form Return.
MCEDT available reports to download
eSubmit AIRs and RAI responses were previously communicated to providers in MCEDT with file type GCM and subject General Communications.
Providers will now see them under file type EFR, with subject eSubmit Form Return.
Additional Information Requests file name
The new file name format for eSubmit AIRs is Claim Submission Number (CSN-the Provider Number if a solo claim or Group Number if a group claim), ADD, Group Number, Provider Number and eSubmit Ticket Number.
The file name will appear in the following format: CSN_ADD_0000_123456_eSubmitTicketNumber.html
Remittance Advice Inquiry Responses file name
The new file name format for eSubmit RAI Reponses is: CSN, RAI, Group Number, Provider Number and eSubmit Ticket Number.
The file name will appear in the following format: CSN_RAI_0000_123456_eSubmitTicketNumber.html
Additional resources and information can be found on the Ministry of Health website.
Keywords/tags
eSubmit; Remittance Advice Inquiry; RAI; Supporting Documentation, Additional Information Request
Contact information
If you have questions about this INFOBulletin? Email the Service Support Contact Centre or call