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Telephone: 1-800-668-7347 ex. 28

Fax: 416-694-9172

Email: info@ohipbillingagents.com

Web: www.ohipbillingagents.com

Online Questionnaire

* Dr. First Name

* Dr. Last Name

* Clinic/Hospital Name

* Clinic/Practice Specialty

Address

City

Province

Postal Code

* Telephone Number

Fax Number

* E-mail

* = Required

1. Do you currently have a computer?
Yes (Proceed to #2.1) No (Proceed to #2.2)

2.1 What software program do you use?
Please provide name(s): 
(Proceed to #3)

2.2 Do you submit your claims by card or do you use a service bureau?
Card (Proceed to #3) Service Bureau (Proceed to #2.21)

2.21 Which Service Bureau do you use?
Please provide name(s): 
(Proceed to #3)

3. How many OHIP claims do you process per month?
0-100 200-400  400-800  800+

4. What is the average dollar amount per claim?
$

5. What percentage of your claims are:
OHIP% WSIB% Direct% 3rd Party% FAS% Reciprocal%

6. On average how much time per day is spent on claims processing?
less than 2 hrs 2.5-4hrs 4.5-6hrs 6+hrs

7. On average how much time per day is spent on claims follow up?
less than 2 hrs 2.5-4hrs 4.5-6hrs 6+hrs

8. If possible what changes would you make to the way your practice processes it’s claims?

9. Have you considered electronic data transmission (EDT) before?
Yes No If yes, why haven’t you proceeded?

10. Have you ever considered an outside billing service before?
Yes No If yes, why haven’t you contracted with them?

Thank you for taking the time to answer these questions. It will help us to better understand your billing needs and what we can do for you. We will get back to you shortly.

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E-mail: info@ohipbillingagents.com