OHIP billing audit and recovery
Responding to a Ministry of Health billing audit and any claim to recover money paid to a physician.
What is included
- Reviews the notice, order, audit or question you are facing
- Explains the law and the regulator's or hospital's process
- Prepares written responses and supporting documents
- Represents you in meetings, reviews or hearings
- Advises on steps to reduce future risk
What is not included
- Independent reports and other disbursements
- Appeals or judicial review unless added to the retainer
- Clinical, billing or management consulting
Who this service is for
- Physicians, nurses and other regulated health professionals
- Hospitals, clinics and long-term care operators
- Professionals unsure of their reporting duties
Information to have ready
- 1The notice, order or audit letter
- 2Relevant policies, records and correspondence
- 3Your registration or licence details
- 4A short timeline of events
How a referral works
- 1Tell us in a few words what the matter is about, and who else is involved, so we can check for a conflict of interest.
- 2We recommend an Ontario lawyer for your matter, and at least one other you could choose instead.
- 3The lawyer runs their own conflict check, confirms the scope and quotes the fee, normally in a written retainer agreement.
- 4You pay the lawyer's fee to the lawyer. Any referral fee comes out of it, is disclosed to you in writing, and never increases what you pay.
NEO Legal Services Professional Corporation is a licensed paralegal firm, not a law firm. Every step of a referral, and your rights
Frequently asked questions
What does the lawyer charge?
Lawyers usually charge $400–$850/hr for this kind of work, by the hour. The lawyer quotes the actual rate and an estimate. You pay the lawyer directly; the referral itself costs you nothing.
Should I respond before speaking to a lawyer?
It is usually better to get advice first, because what you say early can shape the rest of the process. Do not let the deadline in the notice pass while you decide.
Is what I tell the lawyer confidential?
Communications with a lawyer for legal advice are generally protected by solicitor-client privilege.
Do I have to report a colleague or patient concern?
Some professionals have mandatory reporting duties under statute or their college's rules. The lawyer can explain what applies to you and how to report properly.
General information only, not legal advice. NEO Legal Services Professional Corporation is a licensed paralegal firm regulated by the Law Society of Ontario.
Important limitations
- No outcome can be guaranteed
- Regulators' deadlines must be met even while a lawyer is being chosen
- The lawyer confirms the scope, fee and steps in a written retainer before starting
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