Limits and claims

Prepare and check a claim

Move from the app's saved records to your normal OHIP billing process without missing the claim details.

Quick answer: Submit the hourly code for each category claimed on the service date, with the correct units and billed dollar value. FHO+ Billing prepares a summary but does not transmit claims.

Last reviewed September 9, 2026

Before submission

Complete the daily records and activity summaries in FHO+ Billing.
Review the service date against the daily, monthly, and ratio limits.
Generate a billing summary for the same date range and compare it with your billing software.
Use Q310A, Q311A, Q312A, and Q313A only for categories with claimable units that day.
Enter the billed amount as units multiplied by the applicable per-unit value. Do not bill $0.
Include the correct FHO group or solo billing number for your physician status.
Leave the patient health number, version code, and birth date blank on the hourly claim items.

Timing and payment

Hourly claims are paid through the regular OHIP claim process.
OMA guidance says the 90-day stale-date rule applies.
Continue to submit the applicable underlying shadow billing, fee-for-service claims, and other billings.
Each code can be submitted separately, but every item still needs the actual service date.

Check the remittance advice

Code or result	What it may indicate
V41	The hourly code used an incorrect fee, including a $0 billed amount under the May 2026 processing update.
A3H	One claim item exceeded 56 units.
MD	The daily maximum was exceeded.
M5	The monthly maximum was exceeded.

If a claim needs adjustment

Use the normal Remittance Advice inquiry process for an adjustment. OMA guidance points to a bulk-adjustment process when 25 or more claims are affected. Keep the explanatory code, service date, and corrected amount with your billing record.

Important notes

Check the current Ministry and OMA guidance before relying on an explanatory-code summary. Claims processing rules can change.

Sources

Browse all FHO+ Billing guides

Introduction — Use this help center to understand the app, the FHO+ hourly categories, and the checks to make before billing.
Start here — Set up the app once, record the day while it is fresh, and review the month before you prepare claims.
Log a day — Enter the time you worked for one service date and keep the four categories separate.
Read your billing snapshot — Understand the room calculations and prompts that change as you edit a day.
Use the time tools — Measure one work block or total several blocks before applying the result to Today.
Review a month — Use Calendar to find blank days, correct records, and check the month before claim preparation.
Create presets and weekday rules — Reduce repeated entry while keeping the saved record tied to what actually happened.
Export records and prepare claims — Create a readable date-range report and a code-by-code summary for your normal billing workflow.
Manage local data, sync, and backups — Know where your records live before you change browsers, devices, or accounts.
Use FHO+ Billing across devices — Set up FHO+ Billing on web and iPhone with the same account, then check whether your preferences and saved billing records have synced.
Review FHO+ billing records before export — A practical review checklist for Ontario FHO+ physicians using FHO+ Billing to check service dates, categories, limits, saved entries, and reports.
FHO+ billing terms for Ontario physicians — A plain-language glossary of FHO+, hourly-rate categories, Q-codes, rostered patients, billing units, and continuity terminology used in Ontario physician guidance.
If the numbers look wrong — A short diagnostic checklist for totals, room calculations, missing days, and saved data.
Check eligibility — Use the patient, service, physician, and location as the starting point before you choose an hourly code.
Choose a fee code — Keep the four hourly categories consistent in Today, reports, and billing software.
Indirect care vs clinical administration — Separate the two support categories that are easiest to confuse.
Rates, units, and rounding — Convert the time in each category into claim units and the correct base value.
Daily and monthly caps — Check the shared daily maximum and the prorated monthly maximum before submitting a large day or month.
Support-time ratios — Keep indirect care and clinical administration within the two monthly ratios.
Document a claimed day — Keep the daily totals and activity summaries needed to support hourly claims.
Prepare and check a claim — Move from the app's saved records to your normal OHIP billing process without missing the claim details.
Virtual care and other settings — Use location and service type to place virtual care, home visits, and long-term-care work in the right category.
Learners and locums — Apply the hourly guidance when teaching during care or covering an FHO practice as a locum.
Fix common mistakes — Run this checklist before you send a large claim or finish the month.
What changed on April 1, 2026 — A short guide to the FHO+ changes that sit beside the hourly-rate program.
Continuity and outside use — Understand the continuity measure without confusing it with hourly time tracking.
Official sources and dates — Go to the documents that govern or explain FHO+ billing when a rule is unclear.