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Error code

EH5 — Service Date Not in Eligibility Period

Not covered on that date

The service date doesn't fall within any of the patient's eligibility periods, so the claim was rejected.

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

Code
EH5
Description
Service Date Not in Eligibility Period

Explanation

Updated October 26, 2026

EH5 means the patient had no OHIP eligibility on the service date. Check the service date, health number and the patient's coverage.

What it means

EH5 means the service date doesn't fall within an eligibility period for the patient, so the claim was rejected. The patient may have been covered before or after, but not on that date.

The matching Remittance Advice code is E5.

Common causes

  • A gap in the patient's coverage
  • 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 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, correct them and resubmit. Resubmit within three months of the service date if you can. If that window has passed but the claim was first submitted on time, use the Ministry's stale-dated resubmission process.
  4. If the patient wasn't covered, OHIP won't pay. If the patient believes their coverage is wrong, ask them to contact ServiceOntario. Resubmit if their coverage is restored for the service date.

Don't resubmit if

  • The patient had no OHIP coverage on the service date.

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: E5, EH1, EH4, EA

Sources