CNESST
Completing the CNESST account of care and treatment (5055) in Bio6
The full procedure: create the file, code the month's attendance, check the fields the 5055 requires, submit the period and follow the payment through.
Form 5055 is the account of care and treatment the clinic sends to CNESST in order to be paid. In Bio6 it is not completed in one sitting at the end of the month: it is built as the file progresses, then assembled at the moment of submission.
This guide follows the real order of operations, from the supplier number through to payment. For the precise on-screen steps, the help centre covers each page in detail.
What you need to know before starting
If you are arriving in a role where CNESST files are handed to you, this section sets out the pieces before the guide moves into the mechanics.
CNESST pays in place of the patient
The Commission des normes, de l'équité, de la santé et de la sécurité du travail compensates workers who have suffered an employment injury. When the claim is accepted, it is the Commission that bears the cost of physiotherapy and occupational therapy treatment.
The practical consequence for the clinic is straightforward: the worker is never billed. The law prohibits claiming any amount from them for the services they are entitled to. The invoice is addressed to the Commission, and the account of care is the vehicle for it.
Two families of documents not to be confused
A CNESST file produces two types of document, which have neither the same purpose, nor the same recipients, nor the same consequences.
It sets out the treatments provided during a period and the amounts arising from them.
It is sent to CNESST only, and it is what triggers payment.
The initial assessment, the progress report and requested reports describe the worker's condition and its evolution.
They are sent to CNESST and to the treating health professional. They determine whether treatment continues and inform the return-to-work decision.
The two are connected: a late report suspends payment for treatment, even when the accounts of care are faultless.
Who completes the account of care
Form 5055 is completed by a physiotherapist, a physiotherapy technologist or an occupational therapist who is a member of their professional order. Signing reports follows a narrower rule, set out further down.
Care must be billed within 180 days of the date on which it was provided in order to remain reimbursable. This limit is generous day to day, but it becomes real when a file has been set aside while waiting for a response from the Commission.
The prerequisite setting: the supplier number
The clinic's CNESST supplier number is entered in the billing settings. While it is missing, the dashboard indicators stay at zero and submission is blocked for every file.
This number belongs to the clinic rather than to the practitioner. It is entered only once, but a clinic opening a second site should check that the right number is associated with each location.
This is the most common cause of a first submission failing. If the dashboard shows zeros while files exist, check this setting before anything else.
Step 1: create the file
The New file button opens the intake form, which corresponds to the identification part of the 5055. It is quicker to gather the information before starting, since several items come from different documents.
The patient, their health insurance number, their postal code, their occupation and their dominance, along with the employer at the time of the injury.
The CNESST file number is nine characters. A shorter entry is flagged at the check.
The date of the event, the treatment start date, the diagnosis, and where applicable the date of relapse.
The date of the event is that of the accident, not that of the first visit to the clinic.
The name and licence number of the prescriber, the prescription date, and the phone number of their clinic.
This information appears on the prescription itself. Entering it at the outset avoids having to find the document again at the end of the month.
The discipline, physiotherapy or occupational therapy, and the treating practitioner with their licence number.
The same patient may have two active files at once, one per discipline. They are followed separately.
Step 2: code the month's attendance
The attendance grid displays a full month, one row per file, grouped by patient and by discipline. The columns are the days of the month.
When an appointment exists in the calendar, a dot appears automatically in the corresponding cell. This dot indicates the patient's attendance, but it is not yet a billable code.
To code a day, click the cell: the list of attendance codes appears, filtered according to the file's discipline. You can also code a day with no appointment in the calendar, which is useful when a session was given outside the schedule. Clicking again on an already coded cell allows the code to be changed or removed.
The grid only displays the selected month. If appointments appear to be missing, check the period selector first before concluding there is a calendar error.
Claim templates, configured in the billing settings, allow combinations of codes to be prepared by type of condition. A clinic that often treats the same injuries benefits from defining them once rather than recomposing the same sequence every month.
Step 3: check before submitting
The Submit button first opens a check, before any transmission. Each file in the period is placed in one of the following three states.
| State | Meaning | Action |
|---|---|---|
| Ready | Every required field is filled and the visits are coded | None |
| Incomplete | Something is missing, specified in the list of reasons | Correct, or submit anyway |
| Already submitted | The period has already been sent for this file | None |
The most common reason is a number of visits without a code, displayed as such: "3 visit(s) without a code". Missing 5055 fields are added to it.
An incomplete file does not prevent submission: the check flags the gaps without blocking them. This flexibility is useful when a piece of information is legitimately absent, but it does require reading the list rather than scrolling past it.
The fields that are checked
The check covers the following items. The first four concern the clinic and are settled once and for all; the others are specific to the file.
- Supplier number, clinic phone and fax numbers
- Licence number of the treating practitioner
- CNESST file number, in nine characters
- Health insurance number and postal code of the worker
- Date of the event, prescription date, treatment start and end dates
- Diagnosis and discipline
- Treating practitioner assigned, prescriber with their licence number
- At least one visit code in the period
Step 4: submit and transmit
Once the check has passed, submitting marks the period as sent in Bio6 and produces an archive containing the 5055 forms for the period.
Bio6 prepares the forms, but does not transmit them to CNESST. There is not yet a direct link with the Commission's system. Sending is done with the files produced at this step, through CNESST's electronic document transmission service or by fax.
The Submissions view then brings together the periods that have been sent and are awaiting payment, with the amount calculated from the codes and the rates in force. When payment is received, the period is marked as paid there. It is this view that gives the real state of CNESST receivables, rather than the total billed.
Completing a progress report
The account of care settles the billing, but the file also requires reports. The rehabilitation progress report, the NI-4, is produced at regular intervals during care, and an occasional request from CNESST has a direct effect on payment.
Recording the request
The Physio/OT reports view keeps the inventory of requests received, separated into pending requests and submitted reports. The add button records the request number, the file concerned, and the date on which the request was made.
Enter the date shown on the request rather than the date it reached the clinic, since that is what starts the fifteen-day clock.
Preparing the narrative
Bio6 can produce a first draft of the narrative in French from data already in the record: the sessions in the period, the evolution of pain and functional scores, and an index of readiness to return to work. The period used defaults to the last fourteen days and remains adjustable.
The text is organised according to the report's usual sections: clinical evolution, functional measurements, capacities and limitations, a return-to-work recommendation to be validated, and the treatment plan.
Two characteristics are worth knowing before relying on it.
The values come from the structured data in the record and not from the language model, which merely turns them into continuous text. Missing data is flagged as undocumented rather than filled in.
The return-to-work index requires at least two pain measurements in the period. Below that, the report indicates that the data is insufficient.
Bio6 transmits no report and completes no official form. The text produced is a draft for the clinician to review, and every draft states this explicitly.
The return-to-work recommendation is presented as something to be validated. The decision remains the clinician's.
The narrative is built without identifiers: no name, no date of birth, no health insurance number. The text refers to the worker. You add the identifying information yourself when transferring the content into the official form.
Producing the draft requires content generation to be enabled in the clinic's artificial intelligence settings. The guide Making the most of Bio6's AI details those settings.
Review, transmit, then mark as submitted
Read the draft through, paying attention to the sections where data was missing, then transfer the validated content into the form required by CNESST.
The report is sent to CNESST and to the treating health professional. It is this second recipient that is most often forgotten, since only the transmission to the Commission affects payment.
Then mark the request as submitted in the reports view. It moves to the list of submitted reports, where the submission date, the person who completed the report and the state of the response are kept.
Notices received from CNESST
Notices received, whether a stoppage of coverage, a request for a report or a payment notice, are recorded manually in the notices panel. There is not yet any automatic link with CNESST, so a notice received by post has to be entered in order to appear in the table. Files with an open notice can then be found using a dedicated filter.
Archive rather than delete
A CNESST file is a document with medico-legal value. Bio6 therefore distinguishes two operations that look similar on screen.
Archiving removes the file from the active list while keeping its history, which remains available under the archived files filter and in the patient record. The operation is reversible in one click. It is the normal tidying-up action, once treatment has ended and the period has been paid.
Deletion is reserved for files created in error. The file then disappears from every view and only an administrator can recover it. Nothing is permanently erased, but the operation requires explicit confirmation.
When in doubt, archive. An archived file can be found again; a deleted one requires intervention.
The deadlines to respect
The mechanics in Bio6 do not remove the regulatory deadlines. Here they are, with the date from which each is calculated.
| Deadline | Calculated from | Delay |
|---|---|---|
| Account of care and treatment | The date of the initial assessment | 7 days |
| Progress report | The previous report or the start of care | Every 21 days |
| Report requested by CNESST | The date of the request | 15 days |
| Billing for care provided | The date the care was given | 180 days |
The progress report is sent to CNESST as well as to the treating health professional. It is this second sending that is most often forgotten, since only the transmission to CNESST affects payment.
Since 29 June 2023, the initial assessment must be performed by a physiotherapist in order to be reimbursed, and only physiotherapists and occupational therapists may sign and transmit a report after taking on the case.
The regulatory rules cited here come from CNESST and OPPQ documentation, current as at 16 August 2026. The Regulation respecting medical aid has already been amended, and the fee schedule is revised more often than the deadlines. Confirm the amounts and the deadlines on the official pages before turning them into an internal procedure.
Sources and official pages
- Physiotherapy or occupational therapy intervention, CNESST
- Account of care and treatment of physiotherapy or occupational therapy, CNESST
- Physiotherapy report, CNESST
- Fees and billing in physiotherapy or occupational therapy, CNESST
- Amendments to the Regulation respecting medical aid, OPPQ
For the clinical context of these files, see the occupational rehabilitation page.
More guides
- Moving to Bio6 in 30 daysA four-week migration plan for a clinic changing software: who does what, in what order, and the difficulties to expect along the way.
- Making the most of Bio6's AI in your clinicWhat Cortex, Scribe and clinical relevance actually do, their usefulness in a clinic week, how to deploy them and what precautions to take.
- Opening a new clinic on Bio6Setting up a clinic from scratch, in the order of the startup guide: profile, team, first patient, first appointment, billing.
- Getting started with BioBandA guide for pilot clinics: pairing the band, positioning it, running a first assessment, and reading the measurement correctly.
- Reducing no-shows and missed appointmentsWhy a clinic can hold every patient phone number and send no reminders at all, how to choose when they go out, and the cancellation policy that makes the difference.
- Running a successful clinic pilotHow to scope a four-week pilot, define success criteria before starting, choose the participants, and reach a decision you can defend at the end.
- Standardising your assessments with PROMsChoosing the questionnaires, deciding when to administer them, and reading a change in score: what makes results comparable across clinicians and over time.
- Configuring the phone assistantAnswering the calls nobody picked up: the forwarding to set up with your provider, the transfer line, and the thirty-second test that confirms it all works.
- Opening online booking without losing control of the scheduleThe confirmation mode, which services to open first, the booking window, and what to watch during the first month.