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.