When a patient’s health card is invalid or becomes invalid after a claim has been submitted, HYPEMedical provides warnings and structured handling to ensure you can correct and resubmit efficiently.
There are two main scenarios:
Invalid at the time of claim creation
HYPEMedical will display a warning indicating that the health card is invalid.
The claim can still be saved if the user clicks Save.
Valid at the time of submission, but becomes invalid later
The health card was accepted during claim creation.
The card later expires or becomes invalid after the claim is submitted.
The claim remains saved, pending an official rejection response from OHIP.
A claim’s status changes to Rejected only when an Error Report from OHIP is received and processed by HYPEMedical.
If no error report has been downloaded or processed, the claim will remain in Submitted status.
If the claim triggers an “Invalid Health Card” response from OHIP:
Wait for the Rejection File to arrive and automatically update the claim’s status to Rejected. Then fix the claim and resubmit.
If the claim is older than six weeks (Unresolved) and your last submission is more than one week old:
Manually correct the error and resubmit the claim.
If you believe a rejection file should have been received but wasn’t:
Review the claim and resubmit manually after correction.
There are several possible reasons:
HYPEMedical has not downloaded or processed the report yet.
The claim was submitted using an older version of HYPEMedical.
OHIP has not released the rejected claims file.
Other network or timing factors.
To ensure claims are always resolved promptly:
Monitor claims older than six weeks.
Regularly check for new Error or Rejection reports.
Resubmit corrected claims when appropriate.
Following these steps helps keep your billing cycle accurate and up to date.