All SEAMO-funded physicians, excluding those in the Department of Family Medicine, must use SEAMO Billing Services software to process all SEAMO-related OHIP claims. This can be done using one of two service models:
The full-service model is provided by SEAMO Billing Services (SBS). Claims submission and follow-up, error correction, payment reconciliation, OHIP physician group registration, preparation of ad-hoc or routine claim audits and identification of claim maximization opportunities is performed by certified billing clerks with expertise in a multitude of specialties. The cost of the full-service model is 1% of the value of approved claims.
For more information, or to register, call 613-549-6666 ext. 3441 or email firstname.lastname@example.org.
Physicians using the self-service model submit claims using specialized software. Physicians, or an external billing agent of their choosing, are responsible for entry, submission and follow-up of claimdata, error correction, payment reconciliation, OHIP physician group registration, and ensuring the safety of patient information. Software licensing fees are currently paid by SEAMO, however, individual physicians assume the cost of claims processing.
For more information, or to register, call 613-533-6000 ext. 77082 or email email@example.com.
View a comparison of the two service models
For information about the Ontario Ministry of Health Schedule of Benefits, visit their website.
For information about the changes made to the Virtual Care Framework as of December 1, 2022, please watch this video of a webinar with SEAMO Billing Services Manager Melanie Pride answering questions and/or read through this document outlining the key points.