The RA shows it's paid but HYPEMedical doesnt have the claim anymore?
This most often occurs when users edit a submitted claim and resubmit it. The permision to edit claims in the Submitted status should be reserved for administrators.
In the following example the service date was edited after the claim was submitted in a batch to OHIP:
- Code X was billed for 26th (service date) on claim Y
- Claim Y was submitted in a batch
- The service date was edited on for code X on claim Y, from the 26th to the 27th
- Claim Y was submitted in a batch, again.
- Both claims were processed by OHIP
- The RA comes in
Where should the processing of the claim for the 26th be reflected if you have deleted/replaced/edited it?
The service code's only entry in HYPEMedical is for the 27th. The RA cannot match a service date for the 26th as it is no longer in HYPEMedical's database.
The Unmatched section of the RA includes all service codes that can not be found in HYPEMedical's.
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 ...
How do I group totals inside the RA file?
The RA file itself does not contain enough data to total different datasets. However, HYPEMedical can combine an RA file with data from its billing tables as a .csv download. The added data can filter the .csv file in MS Excel. We knew that, ...
Where can find my RAs and transfer them to PDF?
To Find your RAs click on Claims in HYPEMedical's main menu and choose MCEDT Files. HYPEMedical's main menu Once the MCEDT Files page loads click on the Remittance Advice Files tab. In the Remittance Advice Files tab hover over the red arrow and ...
How do I create an RA Inquiry in HYPEMedical?
One Click - Creating A RA Inquiry, In HYPEMedical: Step 1: Find and open the claim in the Claim \ Claim Details page: Click the Add/Edit RAI Note(s) button. Type your Note(s) and Save the Add/Edit RAI Note(s) form Unchecking the service code checkbox ...
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 ...