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Error code

E5 — Service date not within an eligible period

Not covered on that date

The service date falls between the patient's eligible periods, so the patient wasn't covered that day.

What to do: Check the service date and health number against the chart, and validate the health card for that date.

Code
E5
Description
Service date not within an eligible period

Explanation

Updated October 26, 2026

E5 means the patient had no OHIP eligibility on the service date (it falls between eligible periods). Check the date and coverage.

What it means

E5 appears on the Remittance Advice (RA) when the service date doesn't fall within any of the patient's eligible periods. The patient may have been covered before and after, but not on that date.

OHIP doesn't pay for services when the patient wasn't eligible.

Common causes

  • A gap in the patient's coverage, for example coverage lapsed and was later restored
  • The service date on the claim is wrong
  • The claim carries another person's health number

How to fix it

  1. Check the service date and health number on the claim against the chart.
  2. Run a health card validation check for the service date, or ask the patient for their current card.
  3. If the claim details were wrong, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with the correct details.
  4. If the patient wasn't covered on that date, OHIP won't pay. If the patient believes their coverage is wrong, ask them to contact ServiceOntario.

Don't resubmit if

  • The patient had no OHIP coverage on the service date.
  • The claim is already on your RA. A new claim for the same service will be treated as a duplicate. Use an RAI instead.

How APEX handles it

APEX reads your error reports and remittance advice from MCEDT and lists claims rejected with this code in its Correction Centre for you to correct and resubmit. See how APEX works · Pricing

Related codes: EH5, EA, E1, E4

Sources