If you review your OHIP Remittance Advice (RA) in HYPEMedical and see a rejected or unpaid service code that you do not remember entering, the new code may have been added as part of OHIP's adjudication of the original claim.

Why Did a New Service Code Appear?

When OHIP determines that the service code originally submitted was not appropriate and identifies an equivalent service code, OHIP may return the equivalent service code on the RA.

When HYPEMedical processes the RA, it:

• Adds the new equivalent service code returned by OHIP to the claim.
• Keeps the original service code in the claim.
• Identifies the newly added RA service code as an RA (new item).

HYPEMedical does not replace or remove your original service code automatically.

Keeping both items allows you to see what was originally submitted and what OHIP subsequently returned on the RA.

How to Find RA-Added Service Codes in Bulk

You can quickly locate claims containing new service-code items added from an RA.

1. Go to Billing Cycle.
2. Click Advanced Search Options in the green horizontal bar at the top.
3. Select the Service tab.
4. Check the RA (new item) checkbox.
5. Add any other search criteria you require, such as a Service Date or date range.
6. Click Find.

HYPEMedical will display claims containing service-code items that were newly added while processing the RA.

Recommended: Declutter the RA-Added Items

After reviewing the search results, you may want to close the newly added service codes so they no longer remain among items requiring attention.

Once the results are displayed:

1. Select the applicable items.
2. Click the blue bulk Close command button.

This closes the new RA-added service-code items in bulk.

What Should I Do With the Original Unpaid Service Code?

The original service code remains in the claim because HYPEMedical does not automatically delete the code you originally submitted.

After reviewing OHIP's adjudication, you may decide to dispute OHIP's decision or agree with it. If you agree the original unpaid service-code item should be deleted or closed.

Option 1: Use Bulk Edit

From the Billing Cycle search results:

1. Select the applicable claims.
2. Click the blue bulk Edit button.
3. Review and remove the original unpaid service-code item where appropriate.

Option 2: Open the Claim Details

You can also review individual claims directly:

1. Move your pointer to the red arrow on the far right of the claim.
2. Right-click the Claim Detail link.
3. Open the Claim Details page in a new browser tab.
4. Scroll to the bottom of the Claim Details form.
5. Open the Actions menu.
6. Choose either:
   • Delete the service-code item, or
   • Mark the Item as Closed.

In Summary

Seeing a service code on your RA that you did not originally enter does not necessarily mean that someone changed your claim manually.

The typical sequence is:

Original service code submitted → OHIP adjudicates the claim → OHIP returns an equivalent service code → HYPEMedical adds that RA service code to the existing claim.

The original service code remains available for reference, while the new RA-added item can be found using Advanced Search Options → Service → RA (new item).