OHIP Remittance Advice code J3

Remittance Advice
Administrative

Approved for stale dated processing

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.

A submission or documentation step

Something about how the claim was submitted needs to change: a missing field, a manual-review indicator, supporting documentation, or prior approval. Follow the instruction in the ministry's description, then resubmit.

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

  • 62 · Claim assessed by Assessment Officer
  • AP · This payment is in accordance with legislation. If you disagree with the payment, you may appeal to the General Manager
  • EN · Network billing not allowed
  • H8 · Hospital number and/or admission date required for in-hospital service
  • P8 · Health Care Connect greater than 3 months
  • SN · Multiple Surgical Anaesthesia. Documentation of Separate Surgeries Same Day/Same Patient Required
  • W3 · Warning: Service date is older than 3 months
  • W4 · Warning:-service location indicator code missing

Know what J3 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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