WSIB Billing Commonly Asked Questions (And Answers!)

There is a lot of confusion surrounding exactly how to bill WSIB.  We have heard all kinds of issues raised surrounding WSIB and hopefully this blog entry will help to clarify some common misunderstandings.  Over the next few weeks will be creating more blogs dealing specifically with WSIB related issues.

Here are answers to some of the most commonly asked questions we have received from our members:

Q.  Do WSIB and OHIP work together?

A.  Firstly, WSIB and OHIP (or MOHLTC) are completely separate entities and operate independently.  Now with their separate entities being clarified they do periodically cross-audit which is very important to know so that you can understand how important it is that the billing is handled properly.  You definitely don’t want to be on the tail-end of an audit that brings your office to light as being an issue.

Q.  Can I bill WSIB billings electronically?

A.  Absolutely, you can’t bill through your EMR for the forms (8, 26 & FAF) but you can definitely bill through your EMR for office visits and services and it’s not as difficult as you think either.  While in your patient billing screen (within your EMR program) you have options as to whether the billing should be send to HCP (Health Care Plan a.k.a. OHIP), WCB (WSIB) or RMB (Reciprocal Medical Billing Plan).  Most EMR providers default to HCP (a.k.a. OHIP) so that you don’t have to worry about constantly selecting this option.  When billing to WSIB you bill exactly the same codes (Schedule of Benefits codes) you would have billed to OHIP with the only difference being that you will choose WCB to designate the billing as being related to a WSIB claim.  When you submit your files for payment to OHIP the WSIB claim will be sent as well but OHIP will then collect payment directly from WSIB (one part of cross-audit that occurs).

Q.  Why does my EMR billing screen read WCB instead of WSIB

A.  We all know that the Workplace Safety & Insurance Board (WSIB) used to be the Workman’s Compensation Board (WCB).  When WSIB updated their name the OHIP billing system was not able to support a 4 digit acronym so they merely kept their old acronym hence the confusing WCB and HCP acronyms.

Over the next few weeks we will have some more blogs that focus on commonly asked questions so keep checking back! 

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