OHIP Remittance Advice code H4

Remittance Advice
Not re-billable

Maximum fee allowed per week after 6th week to pediatricians

Ontario Ministry of Health, Remittance Advice Explanatory Codes

Where you’ll see it

On your Remittance Advice. The claim was assessed, and this explanatory code says how it was paid, reduced or refused. The Remittance Advice arrives monthly, in the first week.

Resubmitting usually won't change this

OHIP considers the service already paid, claimed by someone else, over its limit, or not insured. A corrected resubmission generally won't be paid. If you believe OHIP's records are wrong, raise it with the ministry instead of resubmitting.

For a claim already on your Remittance Advice, follow the ministry's instruction in the description. That is either a corrected resubmission or a Remittance Advice Inquiry (RAI), and both are still subject to the three-month limit from the date of service.

Our summary is a guide, not a ruling. The ministry’s wording and the current Schedule of Benefits are what OHIP applies. See OHIP Error Report vs Remittance Advice: reading the codes for how the two reports differ.

Related Remittance Advice codes

  • F5 · Two weeks aftercare included in fracture fee
  • G1 · Other critical/comprehensive care already paid
  • H1 · Admission assessment or Emergency department assessment already paid
  • H3 · Maximum fee allowed per week after 5th week
  • H5 · Maximum fee allowed per month after the 13th week
  • H9 · Concurrent care already claimed by another doctor
  • HB · Subsequent Visit Already Paid Same Day
  • HF · Concurrent or supportive care already claimed in period

Know what H4 means before the claim comes back.

Med Copilot records the ministry's codes against each returned claim, explains them, and tells you which ones re-coding can fix. Fourteen days free.

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