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Manual Review

Rob Ward Jun 19, 2013 09:37AM EDT

How do I flag a claim for manual review?

2 Community Answers

Best Answer
Kori Jun 24, 2013 10:30AM EDT

When editing a claim, at the bottom of the screen there is a section titled “Payment Details”. Clicking on that section opens up the payment options for the claim, including “Billing Method” (ie. which group should this claim be paid under), Payment Program (almost always HCP unless the claim is for a non-Ontario patient for an OHIP service provided in Ontario) and Manual Review.

Click the manual review checkbox and save the claim. When you submit the claim, it will be marked as “manual review” for the MOHLTC.

If you are required to send the manual review form, you should now see the claim under File Centre → Manual Review Forms. Click the Trillium icon to generate the pre-filled form, allowing you to print and mail/fax it to your MOHLTC office.

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Up -15 rated Down
Kori Best Answer Jun 24, 2013 10:30AM EDT Clinical Support Systems Agent

When editing a claim, at the bottom of the screen there is a section titled “Payment Details”. Clicking on that section opens up the payment options for the claim, including “Billing Method” (ie. which group should this claim be paid under), Payment Program (almost always HCP unless the claim is for a non-Ontario patient for an OHIP service provided in Ontario) and Manual Review.

Click the manual review checkbox and save the claim. When you submit the claim, it will be marked as “manual review” for the MOHLTC.

If you are required to send the manual review form, you should now see the claim under File Centre → Manual Review Forms. Click the Trillium icon to generate the pre-filled form, allowing you to print and mail/fax it to your MOHLTC office.

Up -7 rated Down
Kori Nov 25, 2013 02:57PM EST Clinical Support Systems Agent

The fax numbers for the various OHIP offices are listed below:

Hamilton (G): (905) 521-7605
Kingston (J): (613) 545-4399
London (P): (519) 675-6832
Mississauga (E): (905) 896-6025
Oshawa (F): (905) 434-4186
Ottawa (D): (613) 237-3246
Sudbury®: (from area 705) (705) 475-675-4015
Thunder Bay (U): (from area 705) (807) 475-1424
Toronto (N): (416) 314-7487

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