OHIP and Other Insurance Audits

Whether billing one’s services to the Governments Insurer (OHIP) or to private insurers, health care professionals are under the computer microscope every day that they submit a bill for payment by any insurer. Unusual billing profiles, a disgruntled employee’s phone call or anonymous letter suggesting billing irregularities in the practice, or a simple computer glitch all routinely give rise to audit investigations that can have more than merely professional or monetary devastating consequences. Any impression or report from the audit that suggests that services billed were not in fact performed or that deliberate misrepresentation of services codes has taken place, can give rise to criminal prosecution and potential loss of one’s liberty.

TTL Health Law has unique expertise in preparing, guiding, educating and representing professionals through the audit process.