Can HYPEMedical create a stale-dated-claim report as required in bulletin 231001?
We are having issues getting errors paid due to the recent changes. We are getting the error code VJ7 - on claims that are over three months old.
Do you have a solution on how to get these processed efficiently? The Ministry states we need to resubmit them but then also send an email. Please see OHIP Bulletin # 231001 (https://www.ontario.ca/document/ohip-infobulletins-2023/bulletin-231001-update-three-month-submission-timeframe-province)
- Send an email to ClaimsManagement@ontario.ca including all of the following:
- Six-digit OHIP billing number and/or four-digit group number. Separate your request by physician and group. Do not send requests for different physicians in one email.
- A list of outstanding claims being resubmitted.
- Confirmation that the stale-dated claim file has been uploaded.
- Corresponding Error Reports for all claims being resubmitted for stale date processing.
Claims should be resubmitted as soon as possible after the rejection date to ensure payment of eligible claims.
Excerpt from OHIP Bulletin # 231001
Yes, HYPEMedical can easily create the report with the Excel button in the Billing Cycle.
The column selection to create a spreadsheet to satisfy points 1, 2 and 4 can be selected in the Billing Cycle.
--------------------------------------------------------------------------
Columns selection for HYPEMedical version 1 users.
--------------------------------------------------------------------------
Satisfying point 3: The Batch Edit file name, confirming the initial Batch Submission upload, is associated with the record of the original Batch Submission in Claim Details.
Next step: In the Billing Cycle hover over the red arrow, of one of the claims, and select Claim Details, choose History and highlight and copy the Batch Number of the original submission batch.
Go to Claims \ MCEDT Files \ Batch Submissions, paste the Batch Number in the search box to find the Batch Submission record, and you will see the Batch Edit file name in the Batch Acknowledgement column.
Related Articles
Billing alerts, reminders and reports?
A set of Quick Reports on the Home page greets the user as they sign in to HYPEMedical. The role of the Quick Reports is to inform and alert the user about the practice's health similarly to an instrument cluster in a car. The dashboard from right to ...Does a Claim have an audit trail that I can easily access?
HYPEMedical maintains a comprehensive record of every activity within the lifecycle of each claim. This record, known as the audit trail, meticulously documents the actions taken, the individuals or systems responsible, and the timing of these ...What are Unresolved Claims?
Un-Resolved is an HYPEMedical tool designed to eliminate stale dated claims. HYPEMedical defines Un-Resolved as unpaid claims with a service date exceeding six weeks from the current date. The Un-Resolved report will alert you to outstanding claims ...Should I be concerned about this code 35?
Should I be concerned about this claim? On the RA, it shows $0.00 paid with a code 35, yet in HYPEMedical it is Paid. Check out the History (Audit Trail) of this claim on the Claim Details page. In this particular case, the audit shows that the claim ...How do I bill OHIP?
Billing OHIP: Click the Claims button in the main menu, search for a patient, and hit Enter. Enter Service codes, and hit Enter. Search or create the next patient, hit Enter, and Go to step #1. Saving a claim for a new patient will also automatically ...