form used for out-patient services incurred by visitors from another province

Form to show all group locations where physician services provided

Form submitted to ministry to obtain Health Number of patient when not available

Form used to record hours of physicians in after hours clinics

form sent to other provinces for reimbursement of inpatient claims paid (reciprocal)

Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI

form used for inpatients to Ontario hospitals who are here visiting from other provinces

form submitted with claims to provide additional information regarding particular claim

form placed on top of bundles of primary care forms, to submit to ministry for processing.

Form completed to request exemption, i.e., no photo to appear on photo health card

Form to request approval for patient to receive surgery In-Province.

Form will be used for NPs to become affiliated with an organization and participate in the NP Service Encounter Tracking and Reporting (SERT) Initiative to receive funding from the MOHLTC

Provider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone

IHPs requesting approval to submit their claims in MRI format

Form used so patient can submit out of country medical receipts

Form used by physicians to make inquiries regarding payment details on Remittance Advice

Form outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.

form used so physicians can have direct deposit of payment of claims

accompanied with form completed by clients to record their wishes for organ/tissue donation

Hospitals submit form to ministry to obtain Health Number of patient when number is not available