What an IHP EDT undertaking asks for — and how to autofill 014-4749-84 with my-id.ca
Sign IHP electronic claims undertakings without retyping provider and organization details
Interdisciplinary health providers enrolling in Electronic Data Transfer must complete an undertaking that repeats organization name, billing identifiers, and authorized representative contact information. This guide is an example of storing them once in my-id.ca.
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): IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement — 014-4749-84
What this form is about
Form 014-4749-84 is the IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement, required when IHPs agree to ministry rules for transmitting OHIP claims electronically.
Before you start: what to gather
- Provider or group legal name and business address.
- IHP billing number and related identifiers.
- Authorized representative name and contact details.
- EDT vendor or software information — confirm on ontario.ca.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your organization name and provider billing details in your my-id.ca profile.
- Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
- Autofill the form. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
- Review and submit yourself through the official channel.
Why do it in my-id.ca
Related Ontario forms repeat the same personal details. Captured once in my-id.ca — stored in Canada, with AI on its own servers — every form starts mostly complete.
Frequently asked questions
- When is this undertaking required?
- When enrolling in or maintaining IHP Electronic Data Transfer — confirm with claims submission guidance on ontario.ca.
- How does my-id.ca help?
- It autofills organization name, address, and billing numbers used on other IHP enrollment forms.
- Is there a separate NP version?
- Yes — nurse practitioners use form 014-4721-84 for the NP EDT undertaking.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.