Additional Information

Last updated December 11, 2021
Created December 11, 2021
Format application/pdf
Form Number https://forms.mgcs.gov.on.ca/dataset/11d55510-b41b-4704-8ead-8bf1cfcc3637/resource/e2984757-5e11-4b9f-8451-49478f3f5d85/download/4747-84f.pdf
Form File Identifier 4747-84
Name English / French - 014-4747-84b - Application for IHP Claims Submission and Remittance Advice in Machine Readable Input (MRI)
Form File Status Available
Description

IHPs requesting approval to submit their claims in MRI format

Language English / French
Functionality Fill and Print
Form File Content Type Form
Remark
Edition Date 2022-11