The product in depth

Every step of an OHIP claim, in one workspace.

OHIPay follows the same four verbs your day already does — prepare, track, correct, and reconcile — and keeps them in one place instead of a portal, a spreadsheet, and memory. The panels below use synthetic sample data.

  • Health-card auto-fill
  • Automatic premiums
  • Advisory pre-check
  • MC EDT submission
  • Remittance matching
01 · Prepare

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're not retyping a name and date of birth. Add as many fee codes as the visit needs; applicable MRP and after-hours premiums, and the day-tiered IPTMA inpatient-rounding codes, are worked out as you enter them. An advisory pre-check flags the entries most likely to be rejected — each warning tagged with the OHIP rejection code it maps to. It is advice, not a gate: a valid claim is never blocked.

  • 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

Health card •••• •••• 4821Verified
Patient M. AlaouiAuto-filled
Codes on this claim
A003AGeneral assessment$36.90
E082MRP premium · +30%$11.07
V21 — no diagnosis code entered yet. You can still submit.
02 · Track

See where every claim stands

Every claim sits in one place, moving through a clear pipeline — Saved, Unsubmitted, Submitted, Paid — instead of being split across a Ministry portal, a spreadsheet, and memory. When you're ready, batch-submit the unsubmitted claims to the Ministry through MC EDT in a single step, and see at a glance what's still outstanding.

  • 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

Saved 3
Unsubmitted 5
Submitted 6
Paid 22
03 · Correct

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 itself, so there's no separate report to cross-reference. Fix the field it points to and resubmit — in one step, from the same screen.

  • The Ministry's rejection reason, shown on the claim
  • One-click fix-and-resubmit
  • No separate report to reconcile by hand

Rejected

Synthetic example

D. Osei · •••• 3305 Rejected
A888ASpecial visit premium$52.30
EH2 — Mismatched version code. Update the health-card version and resubmit.
Fix & resubmit
04 · Reconcile

Match remittance against what you sent

When the Ministry's Remittance Advice arrives, OHIPay reads it and lines it up against what you submitted — claim by claim, code by code — so a partial payment or a quiet rejection doesn't disappear 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 become available.

  • 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

Submitted
$4,812.40
Paid
$4,398.15
Flagged
2 claims
  • A007A General assessment $36.90
  • C122A Inpatient subsequent visit $84.15
  • A888A Special visit premium — rejected $52.30
Total paid this period $4,398.15
More in Prepare

Built for the way you actually see patients

The same claim engine — pricing, premiums, and advisories — backs a few 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 as columns. Tap to bill a patient and the claim is created through the same pricing and advisories as everywhere else.

Health-card scanning

Capture a health card by photo or upload. OHIPay reads the number on the server, verifies it through HCV, and routes a verified patient 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, using reciprocal medical billing (RMB).

See it on your claims

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