Complete your manual review response without retyping practice details

When OHIP flags a claim for manual review, the response form repeats your billing number, practice name, address, and contact information alongside claim identifiers. This guide is an example of storing them once in hivi.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Claims submission — Resources for Physicians — ontario.ca
• Form (Central Forms Repository): Claims Flagged for Manual Review — 014-2404-84

What this form is about

Form 014-2404-84 is Claims Flagged for Manual Review, used by health care professionals to respond when the ministry requests additional information or documentation for OHIP claims selected for manual review.

Before you start: what to gather

• Your OHIP billing number and practice name.
• Claim number(s) or service dates flagged for review.
• Explanation or supporting documentation requested by the ministry.
• Contact phone and email for follow-up.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your billing number, practice name, and contact details in your hivi profile.
2. Keep documents ready. Upload supporting documents to hivi Files so you are not searching at form time.
3. Autofill the form. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
4. Review and submit yourself through the official channel.

Why do it in hivi

Related Ontario forms repeat the same personal details. Captured once in hivi — stored in Canada, with AI on its own servers — every form starts mostly complete.