Can I delete a rejected item in an otherwise PAID OHIP claim?

Can I delete a rejected item in an otherwise PAID OHIP claim?

Instructions for handling mixed status claims:

Prerequisites: Ensure your user account has the necessary permissions to manage mixed status claims. A mixed status claim refers to a situation where service codes within a claim are not all in the same status. This may occur when a claim has been paid with an exceptional service code that wasn't (perhaps it hould not have been billed).

To delete the service code that wasn't paid:

  1. Open the claim in the edit form.
  2. Locate the X icon at the very right of the service code line.
  3. Click on the X icon.
  4. Click Save.
  5. Additional steps:
    1. Checkmark "Save Claim Anyways."
    2. Click Save.

Important Note: Ignore the red warning popup if you do not wish to resubmit the claim. Saving a claim where all service codes are PAID (therefore NOT Unsubmitted) will not trigger the resending of the claim to OHIP.


General Note:
Typically, once an OHIP claim has been processed and contains a rejected item, it is advisable not to delete or modify specific items individually. Instead, you may need to correct the rejected item or submit a new claim with the necessary adjustments.

    • Related Articles

    • Can I delete a duplicate OHIP/medical claim in HYPEMedical?

      Yes, you can; If your user account has the ClaimDelete permission. A duplicate claim occurs when at least one service code for the same service date and health card number exists on two separate claims. Duplicate claims are sometimes allowed in ...
    • 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 ...
    • 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 ...
    • How do I delete an OHIP Claim?

      I billed the wrong patient, how do I delete that OHIP claim if I have already created a newer OHIP claim with the right patient? In HYPEMedical, claim deletion is available in the three places where you would normally search for a claim: The Claim ...
    • What outcomes can I expect for my claim submission to OHIP?

      There are four possible outcomes or scenarios: The Four Scenarios Most OHIP claims follow the ideal billing flow shown in the rightmost flow chart (Best Scenario). In the "Best Scenario" a Claim is entered and saved to the UNSUBMITTED status, then ...