Should I be concerned about this code 35?

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 was edited three times before it was fully paid, and the last resubmission was an edit after payment was made. That is why the already-paid items were flagged with code 35.

A claim with paid service codes, especially a complex claim, may be edited and resubmitted.
OHIP's software will automatically flag each previously paid service code with rejection code 35.

OHIP's RA communicates with HYPEMedical. The RA in this example shows that OHIP paid $0.00 for a service code and flagged it with rejection code 35. HYPEMedical added $0.00 to the already paid service code. Therefore the totals balance.


    • Related Articles

    • The Claims' Audit Trail

      How can I trace a particular claim throughout its life cycle? HYPEMedical automatically keeps a trail of every event in each claim’s life cycle. HYPEMedical keeps detailed notes of who/what did what and when from the moment a claim is created. This ...
    • 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 ...
    • 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 ...
    • 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 ...
    • I have OHIP claims in September that are still sitting in the submitted status. How do I fix that & how did that happen?

      I have looked at your account's Quick Reports on your HYPEMedical's Home page and found 64 Unresolved claims. I clicked on its green icon loading a Billing Cycle report. The same report is accessible directly from Billing Cycle by clicking on the ...