Canada’s coordination of benefits standards require that you submit healthcare services expenses to a patient’s extended health insurer first. Then, the remainder can be submitted to the automobile insurer for a motor vehicle accident claim.
For more information about the coordination of benefits, see A Guide to the Coordination of Benefits booklet, which was put together by the Canadian Life and Health Insurance Association.
That means when you create an OCF-21 for a patient who is covered under an extended health care (EHC) plan, the first step is to submit the invoice for charges listed in the OCF-21 to the extended health insurer.
In general, extended health insurers do not accept OCF-21s and usually require invoices to be submitted in a standard format, which means you will want to print your OCF-21 in a format accepted by extended health insurers.
In Universal Office, you have the option to print the OCF-21 B and OCF-21 C in the standard format accepted by extended health insurers. In other words, you do not have to create a second invoice for the EHC insurer. Instead, you can simply choose to print your OCF-21 as EHC invoice.
To begin, please have a completed OCF-21 B or OCF-21 C open. For help creating an OCF-21, see the Create and Submit OCF-21 article.
You will also want to make sure that the EHC information is added to the patient file, as well as in the Other Insurance section of the OCF-21, where you simply answer ‘Yes’ to the question about whether the patient has Extended Health Coverage, and fill out the other relevant details. For help with adding EHC information to a patient case, see the Record Policy Information heading in the Guide to Extended Health Benefits Tracking.
Preview OCF-21 in EHC invoice layout
- Click on the drop-down arrow next to the Preview button located at the bottom of the invoice.
- Select Primary EHC or Secondary EHC option.
The invoice will be printed in a format accepted by extended health care adjudicators, with the invoice addressed to the insurer identified in the Other Insurance section of the OCF-21. The claimant and policyholder information, as well as policy and certificate numbers, will automatically appear right under the ‘Bill To’ information in the invoice. The provider information along with professional designation and college registration numbers appear below the list of services.
Note: As you know, the auto insurer total on the OCF-21 C is calculated based on listed blocks. However, when presenting your invoice to extended health insurers, you will want to list your services and price per service, instead of the Blocks and block fees. When you print the OCF-21 C in EHC or in Private layout, the services will be listed as they appear on page 2 of the OCF-21, but with the regular rates you have established in the system. As a result, the invoice total, when printed in OCF-21 version C format, as opposed to EHC or Private printouts will vary because the sum of the Blocks will be different than the sum of the true value of listed services.
Choosing Your Preferences
When it comes to printing an OCF-21, you have a few options for how you want information to be displayed on the invoice.
For example, if you break down your physiotherapy sessions on the OCF-21 into details such as exercises, IFC, ultrasound, etc., you have the option to list the services as they appear on the OCF-21 or bundle them up and display them as simply “Physiotherapy” on the EHC invoice printout.
Note: By default, the invoice will display the Service Type listed under the College Registration in the Resource manager.
- To change the print preferences, go to Edit > Preferences to open system preferences.
- Select Invoice Settings from the list on your left.
- Check the box next to the following options to group services on the invoices as the provider service type (for example, Physiotherapy, Chiropractic).
- OCF21 To EHC1
- OCF21 To EHC2
- OCF21 To Private