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A man working at a bench in his home workshop with a portable oxygen concentrator beside him.
For vendors and clinic administrators

WSIB billing for respiratory equipment.

The Workplace Safety and Insurance Board (WSIB) is Ontario's workers' compensation insurer. Where a work-related injury or disease is the reason for the equipment, it can authorize the purchase and pay the supplier, and this page is about what that does to your invoice.

Book a demoSee what the board authorizes
Approval before the purchase A claim reference per payer share Payer debt ages on its own

Before the equipment leaves the shelf

What the board decides, and when.

Six rules from the board's own Operational Policy Manual, each one something your invoice depends on. Every entry is sourced and dated at the foot of this page.

A workers' compensation payer

The board may authorize the purchase of health care equipment and supplies when an injured worker needs them because of a work-related injury or disease. The claim has to be allowed with ongoing entitlement, and recent health care reports have to confirm the need and set out the treatment goals, including how long the equipment is needed.

Approval before the purchase

Before new or replacement prescription equipment is bought, the board expects approval for three things: the equipment, the cost and the supplier. If it does not authorize the purchase it is not responsible for the cost, and where the price is above what it would have authorized, it is not responsible for the difference.

The original prescription

The worker gives the board the original prescription, written by the treating health professional, who cannot be the same person who dispenses the equipment. A request for a different type of equipment needs a new prescription, and so does a replacement.

A supplier with an agreement

Workers are expected to buy from an organisation that has entered into an agreement with the board for these products. That supplier bills the board directly and the board pays it, so the worker pays nothing at the counter for an authorized and approved item.

Where the exceptions sit

Payment goes to a worker, or to a supplier without an agreement, only in the five exceptions the board lists: a purchase made before the claim was allowed, an urgent need, equipment needing fitting or precise sizing where there is no such supplier in the worker's community, out of province, and a worker who was never told about the rule.

Not an Assistive Devices Program client

A person eligible for WSIB benefits is not eligible for Assistive Devices Program coverage, so the two shares do not stack on one device. Check which payer the file belongs to before the rule goes on the invoice.

Assistive Devices Program (ADP) billing for CPAP clinics

After the authorization

From claim reference to money in the bank.

Five steps your billing team already works in, with the board's own decision path beside them.

1

Add the board as a payer

The Workplace Safety and Insurance Board sits in the payer directory. Your clinic sets its coverage rule once, as a percentage of a named base or a fixed amount, applied to the whole invoice or to single lines.

2

Record the claim reference

A board decision belongs to a numbered claim. The payer can be set to require an approval or claim reference, and the number is captured on that payer's share rather than buried in a note.

3

Bill the payer separately

The board's share becomes its own numbered invoice addressed to the board, so payer debt ages apart from the patient's and the outstanding-by-payer view tells you what is still owed.

4

Apply one remittance across many invoices

One payment covering twenty workers is entered once with its remittance number, applied across the invoices, and reversed as a whole if it does not clear.

5

Deny, appeal, or return it to the patient

The board asks the decision-maker for a reconsideration first, then takes an Intent to object form, with 30 days to object to a return-to-work decision and six months for any other one. Inside norvelle the refused share is appealed, written off or moved to the patient, and an appeal left unanswered for 60 days goes back to the patient by itself.

In norvelle

One invoice, with the board's share on it.

The invoice is raised at your price. The board's share is a payer allocation on it, and what is left is the patient's.

  • The claim reference is captured on the board's share, and the payer can be set to require one before the share goes out.
  • The patient's remainder is worked out after every payer share, never typed in.
  • Collections and aging chase the patient's portion only, so nobody calls a worker about money the board still owes.
  • Print the payer copy of the invoice, which lists each payer portion and the rule that produced it.
  • Your team sends the invoice to the board. norvelle records the split, the reference and the money.

Questions vendors ask.

Sources

Captured 2026-10-18. Every programme fact on this page was read from the board's own published policies and pages on that date. Programme rules change: check the source before you rely on it.

  • Authorization of health care equipment and supplies, the entitlement criteria, approval before purchase for the equipment, the cost and the supplier, the original prescription from a treating health professional who is not the dispenser, and the repair and replacement criteria: WSIB Operational Policy Manual 17-07-06, Health Care Equipment and Supplies, wsib.ca/en/operational-policy-manual/health-care-equipment-and-supplies (published 2024-12-05).
  • Purchase from an organisation with an agreement with the board, the supplier billing the board directly and being paid directly, the five exceptions, and suppliers not directing workers to pay and seek reimbursement: WSIB Operational Policy Manual 17-01-07, Preferred Supplier of Health Care Products and Services, wsib.ca/en/operational-policy-manual/preferred-supplier-health-care-products-services (published 2024-12-05).
  • Reconsideration, the Intent to object form, the 30 day limit for a return-to-work decision and the six month limit for any other decision, the Appeals Resolution Officer as the board's final decision, the Workplace Safety and Insurance Appeals Tribunal as the external level, and the claim number that identifies a file: wsib.ca/en/injured-or-ill-people/appeals/disagreeing-wsib-decision-about-claim (page updated 2026-06-16).
  • People eligible for Workplace Safety and Insurance Board benefits are not eligible for Assistive Devices Program coverage: Ontario Disability Support Program directive 9.6, ontario.ca/document/ontario-disability-support-program-policy-directives-income-support/96-assistive-devices (updated 2026-03-10).

See a payer share built on one invoice.

Watch the claim reference, the payer invoice and the patient remainder land in one place.
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