How do I submit a claim to Manitoba Health?
Send each claim to Manitoba Health electronically, from your billing software. Paper claims are accepted only in exceptional cases, with Manitoba Health's prior approval. Every claim must be submitted within six months of the date of the service, or it is rejected with reason code C2. Manitoba Health pays twice a month: on the 15th and at month end (Manitoba Physician's Manual, pages CLMST-1 to CLMST-3).
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
Fee box
| Item | Limit | Manual page | Manual dated |
|---|---|---|---|
| Submit a claim | Within six months of the date of the service | CLMST-1 (item 4); CLMST-2 to CLMST-3 | |
| Send supporting documents Manitoba Health asks for | Within six months of the request | CLMST-1 (item 4) | |
| Correct and resubmit a rejected claim | Within six months of the date of the service | CLMST-1 (item 9) | |
| Query a payment you disagree with | Within six months of the date on the Remittance Advice | CLMST-1 (item 8); CLMST-7 | |
| Manitoba Health answers a query | Within 90 days of receipt | CLMST-1 (item 10); CLMST-7 | |
| Payment | Twice a month: the 15th and month end. Two cut-off dates a month. | CLMST-1 (item 2); CLMST-2 | |
| Remittance file ready to download | From the 3rd business day after the cut-off date, until the next cut-off date | CLMST-4 | |
| Manitoba Health pays you interest on an electronic claim it has not paid | If it has not paid the claim within 30 days of receiving it, and the claim had all the required information | CLMST-6 |
When it applies and when it does not
What every claim must do
- Go in electronically. "Claims for insured services must be submitted to Manitoba Health electronically. Paper claims will only be accepted in exceptional circumstances, with prior approval of Manitoba Health." (CLMST-1)
- Come from a clinic that can already send claims electronically. For the set-up or testing of a new clinic, the manual says to contact Practitioner Registry. (CLMST-2)
- Arrive in time. "All claims MUST be submitted within six (6) months of the date of the service." (CLMST-1) The manual also says: "All physicians are encouraged to submit claims on a weekly basis or at more frequent intervals to avoid late claim submissions." (CLMST-1)
- Be for your own work. "Insured service claims may only be made for services rendered personally by the physician." (CLMST-2)
When Manitoba Health will not accept it
- A late claim. "Claims received by Manitoba Health more than 6 months after the service date will be rejected with Explanation of Benefits (EOB) code “C2”." (CLMST-3) The Explanation of Benefits (EOB) code is the reason code Manitoba Health gives for a claim on your payment statement. An extension is possible only in "extenuating circumstances". You ask in writing, with details of what prevented the claim. The manual addresses it to: Director, Insured Benefits, Insurance Division, Manitoba Health, 3rd Floor, 300 Carlton Street, Winnipeg, MB R3B 3M9. (CLMST-3)
- Care for your own family or yourself. "A physician will not claim for services rendered to members of his or her own family, or for services rendered to the physician except in urgent or emergent circumstances." (CLMST-2)
- The same service billed to two payers, such as Manitoba Health and the Workers Compensation Board. "Generally two agencies may not be billed for the same service." (CLMST-2)
After you submit
- Review each Remittance Advice and its reason codes. The manual makes this your responsibility, "on a timely basis". (CLMST-4)
- A claim that needs a correction is fixed and sent again electronically. "A query should not be submitted for claims that require a correction." (CLMST-1)
- A claim listed as pending (reason code 77) is still being assessed. "Please do not resubmit or query claims listed as pending." (CLMST-5)
Worked example
You see a patient on March 10, 2026. Your clinic sends the claim with that week's claims. The Remittance Advice shows the claim rejected. The patient's health number (PHIN) was keyed wrong.
This is a correction, not a query. Fix the health number and resubmit the claim electronically. The date of the service is March 10, 2026. The corrected claim must be submitted within six months of that date. The clock does not start again on the remittance date. (CLMST-1, item 9)
If a claim is paid at an amount you disagree with, that is a query. A query is due within six months of the date on the Remittance Advice. (CLMST-1, item 8)
What is often not billed
A rejected claim that is never corrected is care you provided and were not paid for. A corrected claim is accepted only within six months of the date of the service (CLMST-1, item 9). After that, the claim is rejected as late with reason code C2 (CLMST-3).
Source
Manitoba Physician's Manual, April 1, 2026 edition (with the October 1, 2026 update), pages CLMST-1 to CLMST-7 (Claims Submission and Payment Procedures). Manitoba Health publishes the manual at gov.mb.ca/health/manual.
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
Unbilled is not Manitoba Health or Doctors Manitoba. This page is general information, not a ruling on any claim. Manitoba Health decides what is payable. Check the current manual before you bill.
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