How can I correct the claims that OHIP has rejected?

How can I correct the claims that OHIP has rejected?

To find your Rejected claims:

  1. Hover over the Claims tab and choose Billing Cycle.

  2. Click the blue Rejected button.
    1. Options:

      1. Rejected [All]: a search for all claims rejected by OHIP.

      2. Rejected [Error Report]: a search for claims rejected by OHIP via an Error Report.

      3. Rejected [RA]: a search for claims returned by OHIP via a Remittance Advice (RA) report.

This following assumes that Rejected [All] was selected. Rejected [All] will include rejections from Error (3-character explanation codes) and RA reports (2-character explanation codes).

After clicking on Rejected [All], Billing Cycle results will load a report. 

Find the the column titled Expl. Code (Explanation Code).
Hover over an Expl. Code
  i   and HYPEMedical will display the code's description in a popup. 

The red arrow

    • Related Articles

    • 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 ...
    • How can I find the claims that OHIP has rejected?

      HYPEMedical automatically downloads and processes your OHIP reports. One of these reports, the Error Report, is automatically downloaded and processed by HYPEMedical. Processing the Error report flags claims with errors as Rejected Claims. To find ...
    • 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 ...
    • 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 ...
    • Where can I find the claims I saved?

      How would I edit a claim I have just saved (Unsubmitted) or revise a Rejected claim? First step: go to Billing Cycle. Hover over Claims in the main menu and click on Billing Cycle. HYPEMedical will compile a list of Unsubmitted (Saved by the user) or ...