OHIP error report·EQ6
OHIP error code EQ6: referring provider number not registered
OHIP rejected the claim because the referring or requisitioning provider number is not registered with the Ministry of Health.
Most often affects Internal medicine, Psychiatry, Neurology, Hospitalists, Orthopaedic surgery.
The one-line answer
OHIP rejected the claim because the referring or requisitioning provider number is not registered with the Ministry of Health.
Ministry wording: Referring/requisitioning health care provider number is not registered with the ministry.
Why it fires
- A digit was transposed when the number was entered from a referral letter.
- The EMR stored a number that never existed as a registered OHIP billing number (group number, pager, or CPSO number in the wrong field).
- The referrer is new to Ontario billing and the number on the letter is not yet the number the Ministry has registered, or the reverse: an old letterhead number after the physician changed billing numbers.
EQ6 is an eligibility-style registration check on the referring or requisitioning field. The Ministry’s wording is specific: the number is not registered. That is different from AC4 (the number is the wrong shape or the wrong referrer type for the code) and from ERF (the number is registered but currently ineligible to refer).
Specialists see EQ6 most often on first-time referrers from a new family practice, locum, or out-of-town clinic. The consultation request looks complete. The six digits on the page do not match any live registration. A second pattern is an address-book row that was typed once in 2019 and never checked. Every subsequent consult from that row fails the same way.
EQ6 can also fire on requisitioning numbers for diagnostics, not only on consultations. If your pulmonary function or cardiology professional claims pull the requisitioner from the same stale row, you will see a cluster of EQ6 on the error report rather than a single consult.
What it costs
The claim is rejected before payment. The unpaid amount is the full submitted fee for that consultation or diagnostic service.
There is no partial payment on an EQ6. The item waits on the error report until the registered number is supplied. High-volume consult practices can accumulate a week of unpaid consults from a single bad address-book entry before anyone notices the pattern.
The dollar figure depends on the fee schedule code. Do not treat EQ6 as a $0 “data warning.” It is an unpaid claim.
How to fix it going forward
- Verify new referring numbers against a current source before the first claim, not after the error report.
- When a letter shows two numbers, use the six-digit OHIP billing number, not a group, clinic, or CPSO identifier.
- Retire address-book rows that have produced EQ6. Do not keep overlaying corrections on the claim while leaving the master record wrong.
- For locum and new-to-practice referrers, confirm registration is active on the service date, not only that a number exists on letterhead.
Prevention is a referrer-file problem. Build a rule: the first consult from an unknown number is checked before submission. That takes less time than reversing a week of EQ6.
If your software validates format (six digits) but does not check Ministry registration, you will still get EQ6. Format checks stop V09 and some AC4 cases. They do not prove the number is registered.
Is it recoverable?
Recoverable by resubmission inside the window
Replace the referring or requisitioning number with the number the Ministry has registered and resubmit inside the three-month window from the date of service.
Call or write the referring office for the current six-digit billing number if the letter is ambiguous. Then resubmit. Do not cycle through guessed numbers. Each failed resubmit still consumes time inside the three-month window.
If the window has closed, the claim may be recoverable by written application where you can show the service was provided and the original rejection was a registration mismatch. That is not a routine correction.
For in-province services on or after 1 April 2023, claims must be submitted within three months of the date of service, not six. Ontario INFOBulletin 230402 is the Ministry notice. Many third-party pages still quote six months. That window is closed for current work. If the original claim reached the Claims Error Report inside three months, a corrected resubmission can still be filed after the window in the Ministry's stale-date process. If the claim was never submitted in time, payment may be recoverable by written application. That is not a routine resubmit.
Related codes
Frequently asked questions
- What does OHIP error code EQ6 mean?
- EQ6 means the referring or requisitioning health care provider number on the claim is not registered with the Ministry of Health. Correct the number to a currently registered six-digit billing number and resubmit.
- How is EQ6 different from AC4?
- AC4 means the number is unaccepted for this fee schedule code (format, self-referral, or NP/midwife restrictions). EQ6 means the number is not on the Ministry’s registration file at all.
- Can EQ6 apply to diagnostic requisitions, not only consultations?
- Yes. The Ministry wording covers referring and requisitioning provider numbers. Diagnostic claims that require a requisitioner can reject EQ6 for the same unregistered number.
For how error reports relate to the remittance advice, see how to read your OHIP remittance advice and what rejection codes actually mean. Official wording for this code: OHIP Claims Error Report code list (Dr.Bill ministry-aligned reference).