What an IHP MRI undertaking asks for — and how to autofill 014-4752-84 with my-id.ca
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 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): 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 my-id.ca makes it faster
- Save it once. Store your organization name, address, and contact 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
- How does this relate to form 014-4747-84?
- 014-4747-84 is the MRI submission application; 014-4752-84 is the undertaking signed with enrollment.
- How does my-id.ca help?
- It autofills organization name, address, and billing numbers used on other IHP claims forms.
- Is there a separate EDT undertaking?
- Yes — form 014-4749-84 covers Electronic Data Transfer; MRI uses this 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.