Overview
The New Claim form guides you through creating and submitting claims with built-in validation and automatic fee calculation.Accessing the New Claim Form
- Click New Claim in the sidebar navigation
- Or click the + button from the Claims page
Required Information
Patient Information
Health Card Number
Enter the patient’s 10-digit OHIP health card number. The system validates the card format automatically.
Service Information
| Field | Description |
|---|---|
| Service Date | Date the service was provided |
| Facility | Location where service was rendered |
| Referring Physician | If applicable, the referring provider |
Billing Codes
Add one or more billing codes for the services provided:- Search for the billing code or select from your frequently used codes
- Enter the quantity (number of units)
- The fee calculates automatically based on the OHIP schedule
- Add additional codes as needed
Diagnostic Codes
Select the appropriate ICD diagnostic code(s) that justify the billed services.Fee Calculation
The system automatically calculates:- Individual service fees based on billing codes
- Quantity multipliers
- Total claim amount
Fees are based on the current OHIP Schedule of Benefits. Complex billing scenarios (percentage-based codes, premium codes) are calculated automatically.
Validation
Before submission, the system validates:- Health card number format
- Required fields are complete
- Billing code compatibility
- Diagnostic code requirements
Submitting the Claim
- Review all entered information
- Click Submit
- Confirm the submission
- View the success confirmation with claim details
Saving as Draft
Not ready to submit? Click Save as Draft to save your progress. Access drafts from the Claims page with the “Draft” filter.Tips for Efficient Billing
- Use the Duplicate feature to copy a previous claim for similar services
- Set up frequently used billing codes in your profile
- Use the Calendar view for bulk entry of recurring appointments