Every step of an OHIP claim, in one workspace.
Follow every OHIP claim through its full life cycle in one place, from first entry to final payment. No jumping between a Ministry portal, a spreadsheet, and memory to work out where a claim stands. The panels below use synthetic sample data.
Enter a claim the way you think about it
Start from the patient's health card. OHIPay looks it up through the Ministry's health-card validation (HCV) and fills in the demographics it returns, so you skip retyping a name and date of birth. Add as many fee codes as the visit needs. Eligible MRP and after-hours premiums, plus the day-tiered IPTMA inpatient-rounding codes, are worked out as you type. An advisory pre-check flags the entries most likely to be rejected and tags each one with the OHIP rejection code it maps to. The warning is advice. A valid claim still submits.
- Health-card (HCV) auto-fill of patient demographics
- Multi-code claims with automatic MRP and after-hours premiums
- IPTMA inpatient-rounding codes resolved by day and discipline
- Rejection-code-tagged advisories that warn, never block
New claim
Synthetic example
See where every claim stands
Every claim moves through one pipeline: Saved, Unsubmitted, Submitted, Paid. Nothing is split across a Ministry portal, a spreadsheet, and memory. When a batch is ready, send the unsubmitted claims to the Ministry through MC EDT in a single step. What's still outstanding stays in plain view.
- Saved to Unsubmitted to Submitted to Paid, at a glance
- Batch-submit to the Ministry through MC EDT
- Filter by status or physician to find what's outstanding
Pipeline
Synthetic example · this week
Fix a rejection without the scavenger hunt
When the Ministry rejects a claim, the reason comes back with it. A dedicated Rejected view puts that reason next to the claim, so there's no separate report to cross-reference. Fix the field it points to and resubmit from the same screen, in one step.
- The Ministry's rejection reason, shown on the claim
- One-click fix-and-resubmit
- No separate report to reconcile by hand
Rejected
Synthetic example
Match remittance against what you sent
When the Ministry's Remittance Advice arrives, OHIPay reads it and matches it against what you submitted, claim by claim and code by code. A partial payment or a quiet rejection no longer disappears inside a batch of otherwise-paid claims. You get a per-claim submission summary with paid and rejected outcomes, downloadable statement PDFs, and an automatic poll that pulls remittance reports as they land.
- Remittance Advice ingested and matched line-by-line
- Per-claim submission summary with paid / rejected outcomes
- Downloadable statement PDFs
- Automatic poll for new remittance reports
Remittance summary
Synthetic example · current period
- A007A General assessment $36.90
- C122A Inpatient subsequent visit $84.15
- A888A Special visit premium · rejected $52.30
Built for the way you actually see patients
One claim engine drives the pricing, premiums, and advisories behind every entry point. Here are three more ways to get a claim started.
Billing Sheet roster
A daily inpatient-rounding grid: your patient list for a facility, with the codes you bill most set as columns. Tap a patient to bill, and the claim runs through the same pricing and advisories as the rest of OHIPay.
Health-card scanning
Capture a health card by photo or upload. OHIPay reads the number on the server, checks it through HCV, and sends a verified patient straight into a new claim. Card images are processed in memory and never stored.
Out-of-province billing
Bill patients from any province or territory except Quebec, at the Ontario rate, through the same submission loop. It runs on reciprocal medical billing (RMB).
How OHIPay helps, answered plainly
Does OHIPay stop claims from being rejected?
OHIPay is advisory, not restrictive. It warns you about the entries most likely to trigger a Ministry rejection and tags each one with its OHIP rejection code, so you can fix them before you submit. It never blocks a valid claim.
Does OHIPay validate health cards?
Yes. OHIPay runs a real health-card validation (HCV) against the Ministry and shows the result inline. Mismatched version codes and inactive cards get caught before they turn into an EH2 or eligibility rejection.
Does OHIPay calculate OHIP premiums automatically?
Yes. Eligible MRP premiums (E082/E083/E084), after-hours procedure premiums (E409/E410), and inpatient rounding (the IPTMA macro) are all priced automatically off the correct base. You capture the premiums without memorizing the rules.
Walk through the workspace with your own codes
The quickest way to judge OHIPay is to see it run on the fee codes and diagnoses you bill every day. No commitment. Just a look at how it fits your practice.
Prefer email? Write to hello@ohipay.ca