Report inpatient expense summaries without retyping hospital and patient identifiers

Hospitals and billing staff summarizing inpatient expenses repeat hospital legal name, billing contact, patient name, and health number on every ministry expense summary. 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: Hospital chronic care co-payment — ontario.ca
• Form (Central Forms Repository): Summary of Inpatient Expenses — 014-7179-84

What this form is about

Form 014-7179-84 is the Summary of Inpatient Expenses used by hospitals to report or summarize inpatient charge information as directed by ministry hospital billing rules — confirm reporting obligations on ontario.ca.

Before you start: what to gather

• Hospital legal name, address, and billing contact.
• Patient name and health number when applicable.
• Admission and discharge dates for the stay summarized.
• Expense categories and line items — confirm calculation rules on ontario.ca.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your hospital name and patient identity 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.