OHIP Billing Tip #16 - Reconciliation - Unprocessed Claims


How to Reconcile Unprocessed OHIP Claims

Part of the reconciliation process is to be aware of all unprocessed claims.  Our software generates “Unprocessed Claims Summary Report” which is a dynamic report, and will show all claims submitted after the 18th (usually), rejected claims, saved claims, and error claims (correction needed before submission to MoH). Once claims are paid, it will show in the payment report. Physicians need to watch for claims that show up in the unprocessed claims report month after month and follow up with the MoH regarding the status.

Find your unprocessed claims

1. On the dashboard under REPORTS & FORMS, choose "Basic Reports" and select “Unprocessed Claims Summary”.

Basic billing reports menu

Select the billing report you want

2. This report will show information about all up to date unprocessed claims. There is an option to export as Excel file to save it for personal records. From drop down menu “Export to the selected format” -> select “Excel 97-2003” -> select “Export”.

Select the file format for download


3. Unprocessed Claims Report will show all claims which are still unpaid.

Unprocessed claims report


4. The “Status” column is where the user will see if the claim is submitted, rejected, saved, etc.

  Unprocessed claims summary


Unprocessed claims summary

For more billing tips, please check out our Billing Tip Library.

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