How do I fix OHIP error code HCC?

Check whether the patient was referred to you through Health Care Connect, and with what status. If the patient was not referred as complex-vulnerable through HCC, Q053A does not apply. Remove it and check whether another new patient fee fits. If HCC records are wrong, sort them out with Health Care Connect before resubmitting. Resubmit the corrected claim within three months of the service date. If that window has passed but the claim was first submitted on time, use the Ministry's stale-dated resubmission process.

When shouldn't I resubmit a HCC claim?

The patient was not referred through Health Care Connect as complex-vulnerable.

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Error code

HCC — Health Care Connect (HCC) requirements not met

Q: What does OHIP error code HCC mean?

HCC means Health Care Connect requirements for the new patient fee weren't met: the patient isn't on HCC as complex-vulnerable in 'referred to' status.

Health Care Connect not met

The patient isn't on Health Care Connect as complex-vulnerable in 'referred to' status, so the new patient fee Q053A isn't payable.

What to do: Check the patient's Health Care Connect referral; if not complex-vulnerable, remove Q053A and check whether another new patient fee fits.

Code: HCC
Description: Health Care Connect (HCC) requirements not met

Explanation

Updated October 26, 2026

HCC means Health Care Connect requirements for the new patient fee weren't met: the patient isn't on HCC as complex-vulnerable in 'referred to' status.

What it means

HCC means the claim was for a Health Care Connect (HCC) new patient fee, but the patient did not qualify. The Ministry lists three reasons: the patient is not on the HCC database; the patient is on the HCC database but not as complex-vulnerable; or the patient is on the HCC database but not in 'referred to' status.

The HCC complex/vulnerable new patient fee is Q053A, a one-time payment for enrolling a complex/vulnerable patient referred through Health Care Connect (Schedule AQ2).

Common causes

The patient found you on their own, not through a Health Care Connect referral
Health Care Connect did not identify the patient as complex-vulnerable
The HCC referral had not reached 'referred to' status for you

How to fix it

Check whether the patient was referred to you through Health Care Connect, and with what status.
If the patient was not referred as complex-vulnerable through HCC, Q053A does not apply. Remove it and check whether another new patient fee fits.
If HCC records are wrong, sort them out with Health Care Connect before resubmitting.
Resubmit the corrected claim within three months of the service date. If that window has passed but the claim was first submitted on time, use the Ministry's stale-dated resubmission process.

Don't resubmit if

The patient was not referred through Health Care Connect as complex-vulnerable.

How APEX handles it

APEX reads your error reports and remittance advice from MCEDT and, for many claims rejected with this code, works out the fix for you to approve before it is resubmitted. See how APEX works · Pricing

Related codes: HCE, A3L, EPC