OHIP Error Report vs Remittance Advice: reading the codes
Updated 2026-09-30
When a claim doesn't come back fully paid, it comes back on one of two reports, and the report tells you as much as the code does.
Error Report: rejected before assessment
An Error Report lists claims OHIP refused to process. They failed a check at intake, usually within about 48 hours of submission, and were never assessed.
- Codes are mostly short letter-and-number combinations. The first letters usually tell you the family: patient eligibility and health-card problems (
EH1,VH1), service-code problems (A3E,AD9), provider and registration problems (EF1). - A small set of two-digit explanatory codes also appears on Error Reports (
09,15,21…). - Nothing was paid, and nothing was decided. Correct the claim and send it in again as a new submission, within three months of the service date.
Remittance Advice: assessed, then paid, reduced or refused
The Remittance Advice is the monthly statement of what OHIP assessed. Each line that wasn't paid exactly as billed carries an explanatory code (30, 35, 36, 55…).
- Some codes mean refusal: not an insured service, already paid, or billed by another practitioner.
- Many only explain an adjustment: paid at a different fee under a Schedule rule, or paid according to a previous version of the Schedule. These often sit beside a partial payment, and nothing is wrong.
- If you disagree with an assessed claim, the route is usually a Remittance Advice Inquiry (RAI), unless the code's description tells you to resubmit.
The same code can mean two different things
The two reports come from separate ministry documents, and some code strings appear in both. 09 is an example: always check which report a code came from before looking it up.
Which returned claims are worth working
Sort every returned code into one of these, in this order:
| Kind of problem | Examples | Worth correcting? |
|---|---|---|
| Patient eligibility or details | health number, version code, eligibility dates | Yes. Fix the patient data and resubmit. |
| Wrong fee code for the claim | outside age limit, not allowed alone, not allowed with a visit | Yes. Re-code and resubmit. |
| Diagnostic code | missing or not accepted with the fee code | Yes. Correct the diagnostic code. |
| Submission or documentation | manual review needed, supporting documents | Yes, by following the instruction. |
| Provider registration | specialty restriction, registration dates | Fix with OHIP's registration records, not the claim. |
| Already paid or not insured | duplicate, other practitioner, maximum reached | Usually no. Resubmitting won't change it. |
| Paid per rule | fee adjusted under a Schedule rule | Nothing to fix. |
The last two rows are where time gets wasted: resubmitting a duplicate or a maximum-reached claim only produces the same code again.
Look up any code
Our complete list of OHIP error and explanatory codes has a page for each code on both reports, with the ministry's description and what to do next.
This guide summarises the ministry's Error Report and Remittance Advice code documents for convenience. The ministry's own documents are authoritative.