OHIP error report·ERF
OHIP error code ERF: referring physician number currently ineligible
OHIP rejected the claim because the referring physician number is currently ineligible to make referrals, even if the number is correctly formatted and was once registered.
Most often affects Internal medicine, Psychiatry, Neurology, Hospitalists, Orthopaedic surgery.
The one-line answer
OHIP rejected the claim because the referring physician number is currently ineligible to make referrals, even if the number is correctly formatted and was once registered.
Ministry wording: Referring physician number is currently ineligible for referrals.
Why it fires
- The referring physician has died, retired, or otherwise had billing privileges end, and the number is no longer eligible to refer.
- The number is registered but currently flagged ineligible for referrals on the service date (licence, registration, or ministry status).
- The consultation request is old, and the physician who signed it is no longer eligible, even though your EMR still treats the number as live.
ERF is the status check, not the existence check. EQ6 says the number is not registered. ERF says the number is known and is currently ineligible for referrals. Resubmitting the same number after “confirming six digits” will not clear ERF.
Specialists meet ERF when a long-standing family physician referrer leaves practice and the office continues to use the old letterhead, or when a deceased physician’s number remains in an EMR favourite list. Hospital-based groups also see it when a referring staff physician’s number is deactivated between the date on the consult request and the date you submit.
The service you provided may be entirely appropriate. The Ministry is not judging the clinical consult. It is refusing to accept that billing number as a referring physician on this claim.
What it costs
The consultation (or other referral-required service) is rejected. A visit or assessment that does not require a referring physician may still be payable if you submit the correct listing. The difference between a consult fee and an assessment fee is the usual economic gap, and it depends on the specialty listing.
If you only correct the format and resubmit the consult with the same ineligible number, you still have zero payment. The path that actually pays is either a different eligible referring physician who did request the consult, or billing the assessment/visit listing that the Schedule allows without that referrer.
Do not invent a substitute referrer. If no eligible physician requested the consult, the honest claim is the assessment or visit that matches the work documented, not a consult with a borrowed number.
How to fix it going forward
- Flag EMR referrer records when a physician leaves practice, dies, or tells you their billing number is changing.
- On the service date, treat a returned ERF as a status problem. Do not treat it as a typo.
- For deceased or retired referrers, stop using the number on new consult claims. Document who actually requested the current opinion.
- Separate “number looks valid” from “number is eligible to refer today.”
Address-book hygiene prevents most ERF clusters. When a family practice emails that a physician has retired, update every specialist in your group the same day. One stale favourite list can reject a month of consults.
If your intake copies the last referrer from a previous encounter, you will recycle ineligible numbers onto new patients. Require a current request for each consult claim.
Is it recoverable?
Recoverable by resubmission inside the window
Resubmit with an eligible referring physician if one requested the service, or submit the assessment or visit listing that does not require that referring number. Inside the three-month window this is a corrected claim, not a new clinical service.
Published correction guidance for ERF is to bill an assessment code that does not require a referring physician when the original number cannot be used. That is a fee-schedule choice based on the record, not a way to keep the consult code alive with a placeholder number.
If more than three months have passed since the service date and the item never paid, the claim may be recoverable by written application. Do not assume a consult fee will be paid on an ineligible referrer.
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 ERF mean?
- ERF means the referring physician number is currently ineligible for referrals. The number may be correctly formatted and previously registered. It is not accepted as a referrer on the service date.
- Should I keep billing a consultation after ERF?
- Only if you have a different referring physician who is eligible and who requested the consult. Otherwise submit the assessment or visit listing that matches the documented service and does not depend on that number.
- Is ERF the same as EQ6?
- No. EQ6 means the number is not registered with the Ministry. ERF means the number is ineligible to refer at this time.
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).