Why does the ministry issue one code instead of V65 and V66?

Because a claim missing both fields is usually one cause rather than two. The single code points at an inpatient configuration that was never completed, which is a different problem from two separate oversights.

We only saw V67 once. Is it still worth investigating?

Yes. The code indicates a route through the billing system that was never configured for HIP, so other claims have almost certainly taken the same route. Check how many and which are still inside the submission window.

What if the service was not actually an inpatient one?

Then the indicator is the error. Supplying an admission date for an encounter that had no admission would clear the edit while making the claim inaccurate. Use the indicator that describes where the service actually happened.

OHIP error report

V67

Hospital and emergency equivalent

OHIP error code V67: missing master number and admission date on a hip diagnostic claim

V67 means the service location indicator HIP was included with a diagnostic service billing and both the master number and the admission date were absent. It is V65 and V66 arriving on the same claim.

Ministry wording: Missing master number and admission date. Most often affects Internal medicine, Neurology, Hospitalists.

You already know V67. A single rejection is rarely the whole pile. Specialists we work with recover $10,000 to $100,000+ from rejected and unpaid claims, then average a 20–40% revenue increase within 90 days.

Each minute looking this up is about $5 of clinic time.

1Why it fires
2What it costs
3What you can recover

See what you can recover

V67 at a glance

V67 is a V-series validation edit and the claim is rejected on the Claims Error Report before adjudication. The ministry condition is explicit: it is assigned when a SLI code HIP is included with a diagnostic service billing but a master number and admission date were both not included.

The ministry could have returned V65 and V66 separately and chose to issue a single code instead. That is informative. A claim missing both fields is rarely two independent oversights. It is almost always a HIP configuration that was never set up, so the indicator is being applied without either of the things the ministry requires alongside it.

For a practice, V67 is therefore the most diagnostic code in this cluster. V65 can mean one site was missed. V66 can mean one patient was missed. V67 usually means inpatient diagnostic billing has never been configured correctly, and the claims that have been paid were paid because they were not HIP.

Why it fires

The claim carries the HIP indicator with neither a master number nor an admission date.
Inpatient diagnostic billing was set up by changing the indicator without adding the two fields HIP requires.
The group began billing inpatient diagnostics from a site that has no stored master number and no admission date capture.
An out-patient template was copied for inpatient use and only the indicator was altered.

The template-copy pattern is the most common cause and it explains the shape of the error. Someone needed to bill an inpatient diagnostic service, found the existing out-patient configuration, changed the indicator to HIP and submitted. The indicator is now right and the two companion requirements have never existed.

A new site produces the same result for a different reason. Where the group has not billed inpatient diagnostics from a location before, there is no stored master number to inherit and no step in the workflow that captures an admission date, so the first claims carry neither.

Reading V67 as two mistakes leads to the wrong fix. Correcting the single claim in front of you addresses neither cause, and the next inpatient diagnostic claim from the same route will return V67 again. The thing to correct is the configuration that produced it.

The ministry also maintains V68 for the mirror image, a claim carrying both a master number and an admission date under an indicator other than HIP. Seeing V67 and V68 on the same report means two populations of claims are using the wrong indicator in opposite directions, which usually points at one template being used for both inpatient and out-patient work.

What it costs

The claim is rejected in full and the entire diagnostic fee is unpaid until a corrected claim carrying both fields is accepted.

Nothing part-pays. The claim did not reach adjudication, so the whole professional or technical component is outstanding.

V67 is the most expensive code in this cluster to leave alone, because it signals a systemic gap rather than an isolated one. If inpatient diagnostic billing has never been configured, then every inpatient diagnostic claim the practice has submitted under HIP has rejected, and the volume is however long that has been true.

Each claim carries its own three-month window from its own date of service under ministry INFOBulletin 230402. A backlog of V67 rejections therefore does not expire all at once. It expires continuously from the oldest service date forward, which is why the age of the oldest line on the report decides how much is still straightforwardly recoverable.

Step-by-step: how to clear this rejection

Confirm the line is V67 rather than V65 or V66, because V67 means both fields are absent and points at configuration rather than at one claim.
Obtain the master number for the hospital site where the diagnostic service was performed.
Retrieve the admission date for that patient and that stay from the hospital record.
Confirm HIP is the correct indicator for the encounter, since a claim that was never an inpatient service needs a different indicator rather than two extra fields.
Resubmit inside the three-month window, then work the rest of the affected claims from the oldest service date forward.

Check the indicator before supplying the fields. V67 assumes HIP is right. If the service was actually out-patient and the indicator was changed in error, the correct fix is the right indicator and not an admission date that does not exist.

Supply both fields in one correction. These are sequential tests, so clearing one leaves the other to reject, and a claim corrected twice costs twice as much staff time for the same payment.

Treat the first V67 as the beginning of a backlog review rather than the end of a task. The code indicates a route that was never configured, so the question is how many claims have taken that route and which of them are still inside the window.

Money you already earned, still unpaid

Recovery is separate work from ongoing billing. Charging only a percentage of what we recover, we review the backlog, correct what your documentation supports, and resubmit. Recent engagements have recovered five- and six-figure amounts, including rejected claims well past the 3-month stale dated deadline going back into 2023.

The alternative is usually your evenings or admin blocks, not billable clinic time. No setup or service fees. Every dollar recovered is money already written off, you keep most of it, and you pay nothing if nothing comes back.

“These claims weren’t chased up on. These claims have been stale dated. You add up the volume of money in there and it’s a consequential sum.”

Dr Sanjay Acharya, on what the recovery review found

Show me what is still recoverable

How to fix it going forward

Build inpatient diagnostic billing as its own configuration rather than by editing the indicator on an out-patient template.
Require both the master number and the admission date whenever the indicator is HIP, enforced at entry.
Store the master number against each hospital site before the first inpatient diagnostic claim is submitted from it.
Assign responsibility for capturing the admission date at the point the encounter is recorded as inpatient.

Separating the configurations is the structural fix. An inpatient diagnostic claim needs three things where an out-patient claim needs one, so a shared template will keep producing claims that are missing two of them.

Enforcing the pair at entry removes the possibility entirely. A claim that cannot be built under HIP without a master number and an admission date cannot return V67.

Do the site setup before the first claim rather than after the first rejection. The master number is a fixed attribute of the location and takes minutes to establish, which is the cheapest moment in the whole sequence to spend.

Is it recoverable?

Recoverable by resubmission inside the window

Supply both the master number and the admission date, confirm HIP is the right indicator for the encounter, and resubmit inside the three-month window from the date of service.

Each claim is individually recoverable while it is inside the window, and the correction is administrative. The service happened and the record supports it.

Because V67 usually represents a backlog rather than a single claim, sequence the work by date of service. The oldest lines have the least remaining window, and a backlog worked newest-first loses the claims that were always going to be hardest to recover.

Where the window has closed, INFOBulletin 230402 allows claims that reached the Claims Error Report inside three months to be corrected and resubmitted through the ministry stale-date process, with the report line as evidence of timely submission. Claims never submitted inside the window run through a written application instead, which is a separate process this page does not describe.

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 V67 mean?: V67 means the service location indicator HIP was included with a diagnostic service billing and both the master number and the admission date were absent.
Why does the ministry issue one code instead of V65 and V66?: Because a claim missing both fields is usually one cause rather than two. The single code points at an inpatient configuration that was never completed, which is a different problem from two separate oversights.
We only saw V67 once. Is it still worth investigating?: Yes. The code indicates a route through the billing system that was never configured for HIP, so other claims have almost certainly taken the same route. Check how many and which are still inside the submission window.
What if the service was not actually an inpatient one?: Then the indicator is the error. Supplying an admission date for an encounter that had no admission would clear the edit while making the claim inaccurate. Use the indicator that describes where the service actually happened.

References

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: Ministry of Health, Error Report Rejection Conditions (December 2022).