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MOH Claim Tracking and Reconciliation

This article details where you can view patients submitted MOH claims and how to change the status of payments.

Written by Ayden

After submitting MOH claims, you need to track their progress and reconcile payments when remittance is received from the Ministry of Health. This article explains how to manage claim statuses and reconcile payments in Principle.

This article will explain:

Claim Statuses

MOH claims in Principle go through the following statuses:

The claim has been submitted and is awaiting processing by MOH.

MOH has processed and approved the claim. Payment has been or will be received.

MOH has declined the claim. Review the reason and resubmit if applicable.

Viewing Claims

There are two places you can view submitted claims: At the Patient Level, and at the Practice Level.

At the Patient Level

This is where you can view MOH Claims and Approval Requests specific to the patient.

  1. Navigate to the Patient Profile.

  2. Select the 'Account' tab, then 'MOH'.

3. Here will be 2 sub tabs where you can view any Claim Requests or Prior Approval Requests relevant to the patient.

Information displayed here includes:

  • Claim Status

  • Reference number

  • Date created

  • Claim Type

  • Invoice link

Clicking the three dots beside the Claim Request will allow you to complete a number of actions:

  1. Mark as Approved

  2. Mark as Declined

  3. Cancel Claim

  4. View Forms

  5. Complete Request (If the claim is in draft).

At the Practice Level

The MOH Dashboard (Located from the left sidebar in Principle) is the central hub for managing MOH Claims. It is a practice level view that shows all MOH Claims and Approval Requests across all patients in the one place.

Information displayed here includes:

  • Claim Status

  • Reference number

  • Date created

  • Claim Type

  • Invoice link

Clicking the three dots beside the Claim Request will allow you to complete a number of actions:

  1. Mark as Approved

  2. Mark as Declined

  3. Cancel Claim

  4. View Forms

  5. Complete Request (If the claim is in draft).

Reconciling Claims

Unlike ACC claims (which auto-sync with the provider portal), MOH claims require manual approval marking in Principle once you receive remittance. Check your MOH remittance emails regularly to keep claims up to date.

  1. Locate the claim in the patient's MOH tab or in the MOH Dashboard.

  2. Click the three dots beside the claim.

  3. Click Mark as Approved.

  4. The claim status will update to Approved and the payment will be reconciled against the invoice in Principle.

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