News provided by
Ontario Medical Association
Mar 24, 2026, 09:11 ET
TORONTO, March 24, 2026 /CNW/ – Ontario’s doctors are calling on the provincial government to modernize the province’s outdated OHIP billing system, using innovative solutions like AI to reduce red tape and ensure patients can access the care they need.
OHIP has failed to keep pace with modern medicine, and doctors say it consistently causes unnecessary delays and funding rejections that disrupt the care they provide to patients.
While the majority of OHIP claims are processed automatically, more than 1.16 million cases a year – or over 1,000 a week – are tied up in manual reviews, meaning physicians can wait months or even years to be reimbursed for the care they provide to patients.
This backlog affects care across the province, from lifesaving neurosurgeries to innovative reconstructive procedures like finger reattachments and breast cancer surgeries, and even the critical care of newborns who depend on urgent medical attention.
The administrative burden caused by these billing disputes is pulling doctors away from patients, and the OMA estimates that at least 58,000 additional patient visits could take place each year if these issues were resolved.
“Ontario’s doctors deliver world class care to their patients every day, but the OHIP system that supports that care is decades behind,” said OMA President Dr. Zainab Abdurrahman.
“Every hour a doctor spends dealing with rejected claims or billing disputes is an hour that could be spent caring for patients. Fixing these issues would free up tens of thousands of additional appointments for Ontarians.”
An OMA survey of more than 2,500 physicians found that 90 per cent had claims rejected in 2024, while many reported spending significant amounts of time navigating billing disputes rather than seeing patients.
Doctors say the problem is particularly acute in surgical specialties, where a large proportion of billings are flagged for review even when procedures follow established standards of care.
