< Error codes

Error code

58 — Claimed by another physician within group

Claimed by a group colleague

Another physician in your group already claimed this service for the patient, so it wasn't paid on your claim.

What to do: Ask your group's billing contact who billed the service and when, then decide who actually provided it.

Code
58
Description
Claimed by another physician within group

Explanation

Updated October 26, 2026

OHIP didn't pay this because another physician in your group already claimed the service. Sort out who provided it before doing anything.

What it means

Code 58 is an explanatory code on the Remittance Advice (RA). The Ministry's wording is 'Claimed by another physician within group'. OHIP's records show a physician in the same group already claimed the service, so it wasn't paid on your claim.

Some services can be paid only once, whoever provides them. The Schedule of Benefits says that where more than one physician provides different parts of a listed service, or physicians substitute for one another, only one fee is payable (GP9). Some limits are set for a whole group: A680 (initial substance abuse assessment) is limited to one per patient per physician or practice group, and a practice group includes physicians in the same billing group (A62).

Code 36 is the wider version: the service was billed by another practitioner, group or lab.

Common causes

  • Two physicians in the group billed the same service for the same patient
  • Coverage or a hand-over, where both the covering and the regular physician billed
  • A service limited per group, such as A680, billed again by a colleague
  • A claim billed under the wrong physician's billing number within the group

How to fix it

  1. Ask the group's billing contact which physician billed the service for this patient, and when.
  2. Decide who actually provided the service. The fee is payable only to the physician who provided it, or whose delegate did (GP9).
  3. If the other physician's claim is the right one, nothing is owed on yours.
  4. If the other claim was billed in error, that physician should correct it through an RAI. Then send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the date of the RA the claim appears on, and explain what happened.
  5. If each of you provided a separate, payable service, send an RAI with the documentation for both.

Don't resubmit if

  • Your colleague's claim is the correct one.
  • The claim is on the RA. Billing it again will come back the same way; use an RAI.
  • The other physician's claim hasn't been corrected yet.

How APEX handles it

APEX shows 58 on the claim line and has no correction rule for it. A line that was paid something is not added to the Correction Centre. If nothing on the visit was paid, the visit is listed under Outstanding for you to review; APEX never sends it on its own. If you are handling it through an RAI instead, use Ignore on it so it isn't sent again as a new claim. See how APEX works · Pricing

Related codes: 36, 35, 70, 40

Sources