Just in time for monthly clean up after OHIP submissions, here’s our next installment of the Error Code Series! We’re looking at VH-type error codes, and sharing our experiences with the deluge of VH8’s in 2014.
VH8 – Date of birth does not match health number
VH8’s are very common error codes – they simply mean the date of birth is wrong. The easy fix is to call the Ministry of Health’s IVR system at (416)326-6666, enter the doctor’s pin, and use the OHIP # to get the correct date of birth for the patient. These can be the result of a type-o, or caused by a mismatch between hospital and MOH data on a patient. JCL’s advice? To get claims paid, use the Ministry’s version of the ‘correct’ date of birth.
The VH8 Flood of 2014
One month in mid 2014, we started receiving an incredible stream of error reports with unheard of volumes of VH8 rejections. We got to work chipping away at the errors: calling the IVR system, correcting and resubmitting them. After finding a strange new message on the HIC line that referred callers to IVR to check birth dates, we realized it wasn’t just us – all of Ontario was being inundated with VH8’s! After a few days, we finally got in touch with someone at the Ministry to find out what had happened. The Ministry of Health and Long Term Care of Ontario only started requiring the correct, exact date of birth in 2014! Apparently approximate D.O.B.’s were acceptable before then: you could invert the month and year, be off by a few days (or months!), and claims would still get paid. All of a sudden, the rules were changed, and incorrect dates from years back were all getting kicked out. It was a rough few months – at JCL we still have nightmares about the VH8 craze of 2014…. though I personally preferred the MOH’s version: they had me down as 10 years younger.
VH1 – Health number is missing or invalid
OHIP health card numbers are assigned numbers that must match a specific algorithm in order to be considered valid. Not every 10 digit combination is valid in Ontario. In the case of VH1’s, you may have a typed one or more digits wrong when entering the number, or the patient’s health card number isn’t from Ontario, but could be from Nova Scotia or British Columbia which also have 10 numerics.
VH2 – Health number is not present
The claim was submitted without a health card number in the required field, that is, no number in the OHIP HCP field or the WCB field for WSIB claims. Many EMR’s don’t allow claims to be sent with missing information, so this code is rarely seen in the age of digital health.
VH3 – Invalid payment program
The MOH accepts claims from the following payment programs:
- HCP = OHIP health care plan claims
- RMB = Out of province claims processed through reciprocal medical billing (except Quebec)
- WCB = WSIB (worker’s safety insurance board) worker’s compensation board claims
If your claim has gone in to the MOH, but is not under one of these three payment programs, you’ll get the VH3 error code back. Again, this code is a rarity with electronic submissions.
VH4 – Invalid version code
You’re probably thinking this is an EH2 duplicate. Almost right: VH4 means the version code is not valid, or doesn’t exist. The letters “O” and “I” are invalid version codes, for instance, while many other single letters can be valid version codes (eg: “Q” or “Z”). EH2 refers to expired eligibility of the version code, which doesn’t match the health card for that date of service.
VH9 – Health number not registered with MOH
Finally, this error code will come up when the HCN is not assigned or inactive. This could mean the number was previously valid but the patient then left Ontario. Alternately, the number could be a possible OHIP card number according to the algorithm, but not assigned to anyone at present. In any case, here you’ll have to go back to square one and check that the HCN you have is correct.
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