- What is the final date for mandatory compliance with HCAI?
All Ontario insurers were enrolled with HCAI by March 31, 2010. There is no single deadline for health care facilities.
Health care facilities that were previously enrolled with HCAI between April 2007 and March 2008 will be assigned an “effective” date by which they must be ready to use HCAI for submission of OCFs 18, 21, 22 and 23. Effective dates may be in Tier 1 (April to May 2010), Tier 2 (June to August 2010) or Tier 3 (September to November 2010).
Health care facilities that were not previously enrolled, or are new or are operating under a different name will be assigned an effective date in Tier 3. Check the HCAI Information website for enrolment instructions.
- What does my practice need to do to enrol with HCAI if it isn't already
enrolled?
In general, the enrolment process is as follows:
Web or PMS Users –
- Complete the online registration process by following the instructions in the document called “How to Register (HCAI Web Application). This is available from www.hcaiinfo.ca
- Fax the signed registration details (enrolment form) to 416 497 6505
- Your clinic will be “Approved” or activated 10 business days before your effective date
- To learn what your effective date is, check our website at www.hcaiinfo.ca
DEC Users –
- Contact the HCAI DEC at 1 866 348 9133 and request the registration package.
- Complete the package and fax it to the DEC at 1 866 346 6744
- You will be able to submit OCF to the DEC on your effective date. To learn what your effective date is, check our website at www.hcaiinfo.ca
- How do I determine what my effective date is?
Go to the HCAI Full Rollout Schedule here and locate your clinic’s name on one of the lists published here. The website will also offer guidance if your name isn’t on any of the lists.
- My name isn't on the HCAI Full Rollout Schedule. When do I start to use HCAI?
If your clinic isn’t named in the Tier 1 (published in March 2010), Tier 2 (published in April 2010) or Tier 3 (published in June 2010) lists, you will start to use HCAI in Tier 3, or in the period September to November 2010.
- My practice is enrolled to use the HCAI web application. What kinds of policies and procedures should I set up to ensure compliance with PIPEDA and PHIPA?
When your health care facility enrols with HCAI, you are effectively gaining a new way to access patient health information, i.e., through the web. Persons who are assigned a user profile (username and password) are given the “keys” to the information stored electronically in HCAI. Just as you keep close track of the physical keys that open your front door and cabinets containing patient files, you must treat HCAI user profiles with the same diligence. This means that clinic management should set up processes to:
- Monitor:
- Who has a user profile
- What kinds of information can each user access
- Manage
- Provide appropriate levels of access to each user.
- It is possible to limit the degree of access by customizing each user’s access. Clinic owners/operators should take time to understand this process, so that excessive access is not granted unnecessarily.
- Activate new users that will be authorized to access electronically stored health information .
- Deactivate users who leave the practice so they can no longer access confidential health information.
- Rapid timeframes should be employed (e.g. within 24 hours or as established by the practice) in order to minimize the risk.
- Inform
- Create a list of all users
- In particular, staff should know which users have the “User Administrator” profile, so they can obtain password resets internally when they become suspended
- Familiarize users with the capabilities that are associated with their user profile
- Each practice should have protocols to be followed should a privacy breach occur. Breach notification is mandatory under PHIPA.
- Do teachers who deliver educational service to claimants need to enrol with HCAI?
Teachers that deliver educational services to injured claimants may enrol with HCAI; however they may face difficulties finding an appropriately qualified person to agree to supervise the plan (since teachers are regulated under the Education Act and regulated health professionals/health practitioners generally are not).
One option would be for the teacher to submit the “Education Plan” directly to the patient, with instructions for the patient to submit it to the insurer. This plan would not have to be in the format of an OCF 18.
To invoice, please note that Appendix 2 of the HCAI Rollout Guideline excludes academic training from the requirement to invoice using an OCF 21. This means that the teacher can submit an invoice directly to the insurers.
- Once I am enrolled to use HCAI, will I be able to send fax/mail submissions to HCAI-participating insurers if I don't wish to use HCAI?
No. Health care facilities should be aware that, once you are enrolled with HCAI, you must use HCAI to submit plans/invoices to HCAI-participating insurers. If you do not use HCAI, the plan/invoice will be deemed "not received".
HCAI-participating insurers are prohibited from paying invoices submitted by HCAI-participating health care facilities when submitted via fax or mail.
- What's the difference between AISI Registration versus HCAI Registration?
Auto Insurance Standard Invoice (AISI) was introduced in 2002 and was the first attempt to standardize health claims data reporting for auto collision injury claims. At that time, all health providers were required to register to receive an AISI registration number so they could invoice insurers for health goods and/or services delivered to people injured in automobile collisions.
AISI registration numbers will continue to be in effect until the HCAI rollout has been completed. It is anticipated that full rollout will be completed by the end of 2010. Once rollout is complete, HCAI will become universally used by all Ontario auto insurers and health care facilities providing treatment to persons injured in motor vehicle accidents.
- I am unable to open the application (www.hcai.ca) to enrol.
In some cases, this may relate to security settings and/or browsers that are not set-up to handle the required 128bit encryption level. Some older browsers may have issues with sites that are “https” and don’t switch automatically if you don’t type in the whole address. Here are two strategies to overcome this:
- Type in the entire address exactly as follows and see if you can get in. https://www.hcai.ca
- If that doesn't work, go to the HCAI Information website at www.hcaiinfo.ca and click on "Health Care Providers" and then click on "HCAI Enrolment". On that page you will see a link to www.hcai.ca. Try clicking on that link and see if that takes you to the HCAI web application.
If either of these strategies is successful, bookmark the page in your favourites folder.
- I am unable to print the enrolment form.
You must have Adobe Acrobat reader in order to download the enrolment form. This is a free download, available from: http://get.adobe.com/reader/
- How can I enter a large number of Providers?
The names of each provider that will be delivering services for your health care facility must be entered individually, so their names will populate the health provider drop-down lists that are used for plan and invoice completion.
- Once I have enrolled, when will my Facility be activated so I can set up Users?
During the Pilot or voluntary roll-out phase, your facility will be activated approximately one week before your “effective” date.
- How do I know whom to select for "Contact One" and "Contact Two"? How will their email addresses be used?
HCAI will use Contact One as the main contact to send out information such as outage notifications, notice of new changes, etc. There is no phone number in the Authorizing Officer field, but there is in the Contact One field. If the Authorizing Officer has a different telephone number than the main facility number, the facility may chose to enter the phone number of the Authorizing Officer in the Contact One field.
Contact Two is considered a back-up person who would also receive the information that Contact One receives.
- Is 'Contact One' the main contact that gets e-mail notifications regarding password changes or system maintenance notifications?
Refer to Chapter 3 of the User Manual. The Contact One email address is not used for e-mail notification for password changes. The Authorizing Officer’s address is used for most communications. General communications will also be CCed to Contact 1 and Contact 2.
- What does “Lock Payable” mean and what is a “Payee”?
The “Lock Payable” section will determine whether any user at your practice can change the name to which the cheque is issued when an insurance company issues a payment cheque. In most cases, the facility name will be inserted and “locked” so that insurers automatically receive instruction to issue the cheque to the facility. If you do not lock the payable, users who create and submit invoices can change the name to which a cheque is issued.
The Payee first and last names are based on the fields that exist on a paper OCF 21. If you do not currently use these fields, leave them blank. They are not mandatory.
- Will IBC or HCAI pay for expenses associated with using HCAI?
The online HCAI application will be available to all health care facilities at no charge. For facilities using PMS, IBC has covered the expense of developing an HCAI Integration Toolkit, which was done in consultation with Practice Management Software vendors. This has been provided to any PMS vendor that signs a non-disclosure agreement and will assist the health care facilities using software to seamlessly integrate with HCAI. In addition, a number of workshops have been held with the software vendors and the HCAI team continues to provide support to the PMS vendor community in testing integration.
To determine if there will be additional costs to your facility to use HCAI compatible software, you should contact your PMS vendor.
- I submitted a plan to the insurer before my HCAI effective date. May I use HCAI to electronically invoice for services that were submitted to the insurer by fax/mail?
Yes. Consistent with the answer to the above question, once a health care facility is enrolled with HCAI, the facility must use HCAI to submit plans and invoices to HCAI-participating insurers, regardless of whether the prior document was submitted in paper format.
Do NOT resubmit any forms that have already been submitted to the insurer by fax/mail.
- Does HCAI apply to all NEW patients that are seen by our clinic after our HCAI effective date? Or do we have to use HCAI for all patients, whether they are new or were with us prior to our HCAI effective date?
HCAI must be used for all forms for any patient for whom an OCF 18, 22, 23 or invoice is being submitted. It does not matter if they are an existing or new patient.
- What OCF forms are not to be submitted by HCAI? How do I submit those?
Any OCF form EXCEPT for the ones listed below, must be submitted outside of HCAI, as you do now, whether by mail or by fax.
- OCF 18
- OCF 22
- OCF 23
- OCF 21
Any form that does not appear on the list above must be submitted to insurers using the paper process you used prior to HCAI.
- Will my clinic need to create all OCFs 18s/21s/22s and 23s using HCAI?
If you have enrolled and the date is on or after your “Effective” date, you must use HCAI for all OCFs 18/21/22 and 23. By March 31, 2010, all Ontario auto insurers will be participating in HCAI; therefore no insurer will be accepting paper forms.
- I don’t wish to enrol to use the web version of HCAI. How will I submit OCF 18s, 22s, 23s and 21s?
You will have the option to enrol with the HCAI Data Entry Centre (DEC). If that is your choice, you would prepare your forms as you do now and fax/mail them to the DEC. Once received, the DEC data entry clerks enter your data into the HCAI application and, if the data is complete, the form’s data will be submitted by the DEC to the insurer via HCAI. If the data is incomplete, the DEC will contact you within 48 hours and you will return the error report with the additional required data.
