Sign IHP machine-readable claims undertakings without retyping provider details

Interdisciplinary health providers participating in Machine Readable Input claims submission repeat organization name, IHP billing identifiers, authorized representative contact, and technical contact on every MRI undertaking. 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): Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI) — 014-4752-84

What this form is about

Form 014-4752-84 is the Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI), required when IHPs agree to ministry rules for MRI-format OHIP claims and remittance processing — confirm enrollment steps on ontario.ca.

Before you start: what to gather

• Provider or group legal name and business address.
• IHP billing number and group identifiers if applicable.
• Authorized representative name, phone, and email.
• Technical contact for MRI file transmission.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your organization name, address, 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.