18. Billing

Creating an OHIP Billing Claim

Creating a 3rd Party (Non-OHIP) Billing Claim

To create a 3rd Party claim, you need to toggle the "Billing Type" when creating the claim to 3rd Party - or if it's an IFH claim, IFH, etc.

After creating the claim, you can then enter any payments you've received on the claim, and generate an invoice to give to the patient. For the detailed steps, see the video below.

Avaros allows for both OHIP and 3rd party billing claims to be generated. There are a few different ways to create invoices which will be discussed in this article. Invoices can be created in the following ways:

1. Select the Billing Option on a Patient's Appointment Block ("B")

2. Create an Invoice Directly From the Patient's eChart

3. Create an Invoice From the Patient's Master Record

You can also view the Patient's Billing History and Balances by selecting "Billing History".

Creating an OHIP Billing Claim

Once on the billing screen, please ensure that the patient has a valid HIN, diagnostic code (If needed), and correct Billing Physician. To add OHIP service codes to your invoice, click the check box next to the code you would like to add.

You can also manually enter service codes and unit amounts in the "Special Billing" portion of the screen.

Double-clicking on the service will add it to the Special Billing section. Once the claim information has been entered, click "Next" at the top-right corner of the screen. This will show a Billing Summary where all the claim information can be reviewed before saving. 

Generating 3rd Party/Non-OHIP Claims

In order to set the billing type to 3rd party for private insurance claims or to bill Patient's directly, select "3rd Party" from the Billing Type dropdown box:

The available codes will be updated to list the custom Private Billing Codes for your clinic.

Please see our "Billing Forms & Favourites" article here (Dependency to 23. Billing Forms & Favorites) for more information on how to add additional private codes.

Once you have added the required codes and are ready to bill, click "Next" at the top-right corner of the screen. Here, you'll see the Billing Summary where you can review the invoice details prior to saving.

If the patient will pay immediately upon invoice creation, please choose the billing type they will be paying with (e.g. Visa, Mastercard, Cash) and select "Settle & Print Invoice" instead. This will apply the paid amount to the invoice and render it as settled. Once you've clicked on either the "Save & Print Invoice" or "Settle & Print Invoice" options, the invoice will appear in a new window with the option to "Print".

Once a patient has been billed, the appointment block will turn blue as shown below: