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ClaimsManaging Claims

Managing Claims

The Claims page is the central hub for all your OHIP billing. From here you can create, edit, validate, submit, and track claims.

Claims List

The claims list displays all your claims in a searchable, filterable table. Each row shows:

  • Patient name and health card number
  • Billing codes and fee amounts
  • Service date
  • Status (Pending, Queued, Submitted, Paid, Rejected, etc.)
  • Facility and service location

Searching and Filtering

Use the search bar to find claims by patient name, health card number, or billing code. You can also filter by:

  • Status — show only pending, submitted, paid, or rejected claims
  • Date range — filter by service date
  • Billing code — find all claims for a specific code
  • Payment program — HCP, WCB, or RMB

Views

Toggle between table view (dense, sortable rows) and card view (visual cards with key details). On mobile, claims display as cards automatically.

Quick Actions

From the claims list, you can:

  • Create a new claim — click the New Claim button
  • Edit a claim — click the pencil icon on any pending claim
  • Delete a claim — click the trash icon (only available for Pending, Queued, or Rejected claims)
  • Validate a health card — click the shield icon to verify the patient’s card with OHIP
  • Submit claims — select one or more claims and click Submit to OHIP

Bulk Operations

Select multiple claims using the checkboxes to perform bulk actions:

  • Bulk physician assignment — assign a referring physician to multiple claims at once
  • Bulk encounter editing — update facility, service location, or admission date across claims
  • Bulk corrections — apply AI-suggested fixes to multiple rejected claims
  • Bulk submission — submit all selected claims to OHIP in one batch

Financial Summary

At the top of the claims list, a summary bar shows:

  • Total amount billed
  • Total amount paid
  • Total amount pending
  • Total amount rejected

These totals update based on your current filters.

Privacy Mode

Toggle the eye icon in the header to mask sensitive data (patient names, health card numbers, and amounts) across the entire claims view. Useful when sharing your screen.

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