OHIP claim deadlines: the three-month rule and the monthly cut-off
Updated 2026-09-30
Two different clocks run on every OHIP claim. One decides whether the claim can be paid at all, and the other decides which month it gets paid in. They're easy to confuse, and confusing them is how claims go stale.
The three-month rule (whether it gets paid)
Claims must reach OHIP within three months of the date of service. This has applied since April 1, 2023. Before that the limit was six months, and much of the advice online still says six.
- The clock runs from the date of service, not the date you wrote the note or the date the claim was rejected.
- A rejection doesn't reset it. If a claim is rejected on an Error Report, the corrected claim must still arrive within three months of the original service date.
- Past three months, the claim is "stale dated". Getting it paid needs written permission from the ministry. In practice, treat it as lost.
The dangerous case is the claim that was rejected once and then forgotten. It isn't denied. It just quietly expires.
The monthly cut-off (which payment it lands in)
Submissions received by 5:00 p.m. Eastern on the 18th are processed for that month's payment. If the 18th falls on a weekend or an Ontario public holiday, the cut-off moves to the next business day.
A claim submitted after the cut-off isn't lost. It may just not appear until the following month's Remittance Advice. Missing the cut-off costs you a month of cash flow, while missing the three-month limit costs you the claim.
What comes back, and when
After you upload a claim file through MCEDT, OHIP returns up to four kinds of file:
| File | When | What it tells you |
|---|---|---|
| File Reject | Within hours | The whole file couldn't be read. Nothing in it was accepted. |
| Batch Edit Report | Within 24 hours | Your receipt that the ministry received the batch. It doesn't guarantee payment. |
| Error Report | Within about 48 hours | Individual claims rejected before assessment, each with an error code. |
| Remittance Advice | Monthly, in the first week | What was paid, reduced or refused, with explanatory codes. |
Two practical rules follow:
- Read the Batch Edit Report every time. It's the only proof a batch arrived. No Batch Edit Report means OHIP didn't receive it, and the three-month clock is still running.
- Work the Error Report within days, not at month-end. Every rejected claim on it has the same three-month limit as when it was first submitted.
Return files stay available to download for 12 months. The ministry also recommends keeping batches small (no more than 500 claims), because one bad record can send back a whole batch.
Staying ahead of both clocks
Med Copilot flags visits that haven't been billed and records the codes on every returned claim, so a rejection becomes a to-do on the dashboard rather than something to remember.
This guide summarises ministry publications, including the MCEDT Reference Manual and INFOBulletin 231001, for convenience. The ministry's own documents are authoritative.