Insurers - Previous HCAI Updates

System capacity has been reviewed and is functioning and scaling as expected.
A video email campaign was launched at HCAI users in June to raise awareness about the updated HCAI information website at www.hcaiinfo.ca.
HST was activated in the HCAI system on July 1, 2010.
Auto insurance reforms and HCAI:

HCAI will accommodate the required OCF form (OCF) and process changes for September 1, 2010.
Integration testing for Practice Management System (PMS) vendors and insurers will be available beginning July 26, 2010 to validate the auto reform functionality.

How Is HCAI Working?

Tier 1 Governance Review

System utilization is compared to the capacity plan at the end of each rollout tier to ensure the next tier will not experience a performance issue.

Results at the end of Tier 1: The HCAI system continued to scale well to meet the growing volume. This is expected to continue through Tier 2.

Read More

June 14, 2010 - HCAI Ready to Support Auto Reforms on September 1, 2010

On September 1, 2010, HCAI will comply with the Statutory Accident Benefits Schedule (SABS) reforms.

On September 1, HCAI will accommodate the new OCFs, the new SABS regulation, and the new Minor Injury Guideline (MIG) intervention codes.
HCAIinfo (www.hcaiinfo.ca) will be continuously updated throughout the summer to provide education and information on these changes to the system’s users.

Insurers
As of March 31, 2010, 100% of insurers that write auto policies in Ontario are using HCAI.

Health Care Facilities
HCAI‘s rollout to health care facilities (HCFs) will continue to the end of 2010.

Tier One is complete.
Tier Two is underway with effective dates from June through August.
The Tier Three schedule of effective dates will be published in June.

To view the official list of health care facility participants (updated by the first of each month), visit the Financial Services Commission of Ontario’s (FSCO’s) website at www.fsco.gov.on.ca/english/insurance/auto/hcai.asp and click on the most current HCAI Participating Provider List.

This list posts the names of the HCFs effectively mandated to adopt HCAI as well as their assigned effective dates. It is each facility’s responsibility... Read More

April 12, 2010 - Pilot Phase Successfully Completed

The HCAI voluntary pilot phase is now complete. Over 700 health care facilities (HCFs), i.e., health practices or clinics, enrolled during the pilot stage. Currently, HCAI is successfully processing over 1000 transactions a day with more than 7500 active users on the system.
HCAI technical remediation has been successful and is functioning as expected with no technical or processing issues.
All Ontario automobile insurers adopted HCAI prior to April 1, 2010

What’s Next?

All HCFs that are already enrolled will remain on HCAI and do not have to enrol again.
The adoption process for the remainder of HCFs (i.e., those that have not yet enrolled) is expected to begin late April or early May 2010, as follows:
- HCFs that enrolled with HCAI previously– previously (i.e., between April 2007 and March 2008) will be assigned an “effective date” by which they will be required to use HCAI for submission of OCFs (18, 21, 22 and 23) to Ontario auto insurers.
- The assignment of effective dates will be published in three phases, or tiers.
- The list of HCFs assigned in Tier 1 will be published at http://www.hcaiinfo.ca/Health_Care_Facility_Provider
  /HCAI_Full_Rollout_Schedule.asp.
- If your practice or clinic is named in Tier 1, simply follow the instructions posted on the HCAI Information website.
The list of HCFs assigned in Tier 2 will be published in May 2010.
The list of HCFs assigned in Tier 3 will be published in June 2010.

If your practice or clinic is new or was not previously enrolled with HCAI, you can enrol in Tier 3. Check the website in June... Read More

February 8, 2010 - IBC HCAI Steering Committee accepts pilot findings and recommends that 100% insurer adoption occur in March 2010

Full Rollout – Insurers
On January 26, 2010, the IBC HCAI Steering Committee accepted the pilot findings and made the recommendation to proceed with full adoption by all auto insurers in Ontario by March 31, 2010. The IBC HCAI Steering Committee’s recommendation is currently under review with all governance groups. To view the official list of current participants, visit the Financial Services Commission of Ontario (FSCO) website at www.fsco.gov.on.ca/english/insurance/auto/hcai.asp. The full adoption list will be posted in March 2010.

Full Rollout – Health Care Facilities
The evidence and success criteria from the pilot have been shared with the health care coalition, which represents the health care facilities on the FSCO HCAI working group.... Read More

January 11, 2010 - HCAI Voluntary Pilot Nearing Successful Completion

On September 28, 2009, the HCAI pilot was successfully re-launched with two insurers and nine health care facilities. After three months of operation, the pilot has grown to include 12 insurers and 235 health care facilities, including over 2,100 active users with business representation from small to large insurers and a variety of different types and sizes of health care facilities. We have learned that the system is stable, that no new processing issues have been identified and that the pilot is expected to be successfully completed in February.

In this bulletin, we provide more information about the pilot and identify the next steps as HCAI moves from pilot to full rollout. We also outline the rollout schedule that is anticipated to be completed prior to the end of 2010... Read More

December 2, 2009 - Planned HCAI System Outage December 12-13

Please be advised that the annual validation of the HCAI system Disaster Recovery Plan is scheduled to occur on December 12 and 13, 2009.

During the validation of the Disaster Recovery Plan, the HCAI system will be unavailable.... Read More

November 3, 2009 - HCAI Voluntary Pilot Launched Successfully

On September 28, 2009, HCAI pilot was successfully re-launched. Two insurers, Gore Mutual and State Farm Mutual Auto, and nine health care facilities (hereafter referred to as facilities) began their participation in this voluntary pilot phase. We are pleased to report that no processing issues have arisen after five weeks of active participation by the pilot group.

Re-implementation of HCAI continues as initially communicated. Decisions about enrolling more facilities and insurers will be made on an ongoing basis using evidence-based decision-making to ensure a positive outcome... Read More

September 21, 2009 - HCAI Gears up for launch with new training site for users

This morning, the HCAI Team launched a new & improved HCAI information resource website (www.hcaiinfo.ca) to provide HCAI participants all the tools they need to learn about and use HCAI.

In addition to providing many new resources that were not available on the old site, the new website design organizes information according to the different audiences, so that different HCAI stakeholders can view a homepage specifically designed for their training needs.

The new website contains a wealth of information but it is only the beginning. The information contained on the website will be continually updated and should be seen as the "go to" place for the latest information.

One new tool on the site’s homepage is a barometer of the system’s performance. The barometer is prominently placed and gives an up-to-date reading of how the system is performing at any given time. When users experience a problem using HCAI, they will be able to go here to confirm whether there is a system-wide problem and, if so, what is being done to resolve it.

September 14, 2009 - HCAI Pilot Begins September 2009

HCAI has successfully met the success criteria established and is moving into voluntary pilot in September.

August 21 marked the end of user acceptance testing, also referred to as "Model Office". Voluntary testers from a variety of health care facilities and insurers attended half-day and full-day testing sessions to evaluate how the new HCAI application performed. Three different approaches were used:

Week one was dedicated to the health care facilities to confirm the OCF forms could be created and submitted.
Week two was dedicated to insurers to confirm the submitted forms could be adjudicated.
Week three was an end to end test with both insurers and health care facilities working together to process forms and to confirm the patient transaction from end to end. This event provided an opportunity for both groups to see and understand what happens behind the scenes.

The outcome of the testing provides an important insight into how the remediated system is working. Of all those that attended the session, 100% of the participants indicated HCAI allowed them to perform the tasks that they personally tested.

In addition to the user testing, a third party was commissioned to evaluate performance. This third party report indicates the system could handle 5,000 concurrent users processing 1915 transactions per minute. This level of volume represents 244% of the projected normal volume and over 160% of the expected users. The third party review indicates the system is capable of meeting the daily needs for now and well into the future.

All the success criteria were reviewed in detail by the HCAI steering committee resulting in a recommendation to proceed to voluntary pilot. The evidence was then vetted at a meeting of the HCAI working group that includes FSCO and health care provider representatives on August 21st. That meeting resulted in the health care provider coalition providing FSCO a supporting recommendation to proceed.

On August 26th the HCAI Processing Board approved the move to the voluntary pilot. These approvals have initiated the process to move toward the voluntary pilot of HCAI, with a new guideline that is expected to become effective later in September.

More information on the pilot experience will be provided in October along with more information on the rollout process. Health care facilities interested in using HCAI during the pilot stage may express their interest by emailing facilityenrolment@hcaiinfo.ca. In the subject heading, insert the name of your practice followed by the word "Pilot". As soon as enrollment details are confirmed, you will be contacted by email. Insurers may register with Allison Brand at abrand@ibc.ca.

August 4, 2009 - Remediation of the Health Claims for Auto Insurance (HCAI) system remains on schedule. This update focuses on three key components, Quality Assurance Testing, HCAI system decommissioning and training.

Performance remediation of HCAI remains on schedule to support an HCAI reintroduction September 2009. Further updates on the status of the HCAI testing will be made available the 4^th week of August.

Quality Assurance

Test Results

Both the software vendor and IBC have successfully completed quality assurance testing. The test results have been reviewed and accepted throughthe IBC HCAI governance process.

User Acceptance Testing

Testing sessions have begun and will occur throughout the month of August with Insurer and health care facility volunteers participating in structured test workshops at IBC's Sheppard Avenue location. The results from the test sessions will be included in acceptance criteria, which will be used as part ofthe determination to move into pilot September 2009.

Decommissioning the HCAI System

The old HCAI system was decommissioned July 31, 2009. All access through the Internet and through integration has been revoked. For clarity,all user names and passwords are now void.
Health care facilities and insurers that volunteer to participate in the Pilot phase of reintroduction will have access to HCAI in 2009. Those that do not participate in the Pilot phase will have access in 2010.
Insurance Companies interested in being part of the Pilot should make contact via their Business Leads with an email directed to insurersupport@hcaiinfo.ca.
If your health care facility wishes to volunteer for the Pilot, email providersupport@hcaiinfo.ca.
Schedules for re-adoption of HCAI will be available fall 2009

Instructions on how to re-register or register for the first time will be posted on the HCAI Information website as soon as the details are known.

Training - Insurance Companies

A training survey was released to Insurer Business Leads during the month of July and the responses will guide the training program for Insurers
The Insurer Training schedule for those participating in the Pilot will be released in early fall
Insurers not participating in the pilot will receive their training prior to the end of pilot
The hcaiinfo.ca website has been under construction and will be re-released this fall with many new training tools for Insurer Users.

Training - Health Facilities

Health care facility Training materials are available on the hcaiinfo.ca website. The training materials will be updated in the near future, but the content is still relevant and will assist users in understanding how the web application works.

Health facility "How to" videos can be viewed here: http://www.hcaiinfo.ca/hp-demo.asp
OCF User Manuals can be downloaded from http://www.hcaiinfo.ca/auto-sabs-manuals.asp

Keep checking this website regularly for updates.
If you have a question about HCAI, email providersupport@hcaiinfo.ca.

June 23, 2009 - Remediation of the Health Claims for Auto Insurance (HCAI) system remains on schedule. This update identifies activities and timing of milestone events between now and the end of the program.

HCAI is being reintroduced using a quality review process at each implementation step. If success criteria are not met at a specific step, the schedule will be re-evaluated at that time.

Training will become more important as we move closer to the pilot, which is scheduled to begin in September. The HCAI team will provide opportunities for users to become comfortable with the system prior to adoption. In addition to specific training tools that will be available on the HCAI information website, HCAI will provide a sandbox for individuals to practice using the application.

Initial Testing: June / July

Testing of the HCAI application continues, and all indicators suggest that the system will be ready for reintroduction in the pilot phase as scheduled on September 1, 2009.

Decommissioning the Current HCAI System

In our last communication (May 1, 2009), we informed you that the current HCAI system, which is still being used by some HCFs to create and print OCFs, will be decommissioned on July 31, 2009. Below we clarify the decommissioning process:

The current system will be turned off and will not be available after July 31, 2009. All access through the Internet and through integration will be revoked, and all user names and passwords will become void.
Insurers

Insurer setup information and claim/claimant information will be migrated to the new HCAI environment as insurers enroll in accordance with the adoption schedule.
All insurer data extracts scheduled on or before July 30th will be processed prior to the system being decommissioned.

Health care facilities

The registration and setup information used by HCFs previously registered with HCAI will be migrated to the new production environment in accordance with the adoption schedule. This means that a previously registered facility will only have to update its information – including user and provider lists – rather than re-enter it.
Any HCF that was not previously registered with HCAI (such as a new business) will simply register its facility from scratch.

OCFs

OCFs in the old system will not be migrated to the new system.
If insurers or HCFs wish to preserve PDF versions of OCFs that are currently on the HCAI system, they should download the files to their hard drives prior to July 31, 2009.

Practice Management Software (PMS) Users
The integration tool kit for PMS vendors and developers will be made available prior to the pilot to allow time to integrate HCAI into their practice management tools. PMS vendors opting to integrate with HCAI are being engaged directly by the HCAI team to ensure that testing and validation opportunities are provided prior to the rollout.

Public Testing
Insurer and HCF volunteers will conduct test sessions throughout the month of August, and over 30 sessions have been scheduled. The outcomes will be shared as the testing proceeds.

Pilot Stage
During the initial startup of the reintroduction, two insurers and a handful of HCFs will use the new HCAI system to ensure that the production environment is operating as tested.

In early October 2009, the process will be opened up to a larger community of insurers and HCFs with the intent of creating a user base that reflects 25% of the HCAI transaction volume by the end of the pilot phase, which is currently scheduled for the end of February 2010.

Want to Volunteer?
Health care facilities interested in using HCAI during the pilot stage may register with Viivi Riis at vriis@ibc.ca and insurers may register with Allison Brand at abrand@ibc.ca.

Quality Assurance

The rollout process is driven by a series of control gates that are designed to ensure a positive user experience and avoid adoption problems. The control gate metrics will be reviewed by IBC’s IT Oversight Committee and the results will be shared with several HCAI governance bodies and the HCAI working group , which includes representatives from health care providers and the Financial Services Commission of Ontario.

What Are the Differences from the Last Rollout?

Each rollout phase will use a control point to confirm that the system is capable of adopting the next group of users.
The schedule will introduce OCF transactions volume in a controlled manner.
The regulated adoption will not require HCFs to maintain dual processes.
PMS vendors will be provided a long runway to integrate and validate integration to HCAI.
HCAI has developed and will deploy a set of self-help tools for both insurers and HCFs. These tools will be made available on a redesigned HCAI information website (www.hcaiinfo.ca), which is expected to be available in August during the public testing phase. This website will continue to be available as we move forward.

Full Rollout (Mandatory Enrolment) Schedule

At the end of the pilot phase, the production volunteer experience will be reviewed. If the system has met performance expectations, we expect that regulated adoption will begin in March 2010. The HCAI regulated enrolment process has been designed to avoid any last-minute rollout problems. It is expected that all insurers will be enrolled by the end of March 2010, and that HCFs will enroll in a series of three groupings over an eight-month period (April to November 2010).

We expect that HCFs will be able to determine their groups and schedules for enrolment by reviewing the HCAI Participant List, which we expect will be published on the FSCO website once approval to proceed is received.

Initial Mandatory Adoption Phase

In phase 1, all insurers will adopt HCAI no later than March 31, 2010.
The first 500 HCFs named on the HCAI Participant List will be required by a guideline issued by FSCO to adopt HCAI over the two-month period of April and May 2010.
At the end of the initial adoption phase, the production experience will be reviewed.
If the system continues to meet performance expectations, phase 2 will then commence.

Second Mandatory Adoption Phase

It is expected that an additional 1,500 HCFs as named on the HCAI Participant List will be scheduled to adopt HCAI in June, July and August at the rate of 500 per month.
If the system continues to meet performance expectations, phase 3 will then commence.

Final Mandatory Adoption Phase

It is expected that the remaining HCFs named on the HCAI Participant List will be scheduled to adopt HCAI in September, October and November at the rate of 750 per month.
Any HCF not identified on the HCAI Participant List will adopt HCAI on November 30, 2010.
HCFs that did not exist prior to March 12, 2008 may enroll with HCAI sooner than the final adoption phase by enrolling during the pilot stage.

May 1, 2009 - Remediation of the Health Claims for Auto Insurance (HCAI) system remains on schedule. This update outlines the process that is being used to validate the remediated system and the anticipated schedule for reintroduction of the system.

Validation

The HCAI system began an extended test cycle in April 2009. Testing is being conducted by a quality assurance team within IBC, whose job is to thoroughly review the functionality of the remediated system. This work will continue until July 2009.

In parallel but separate processes, the software developer and an independent third party will validate the number of users the system can support in addition to how fast the system can perform.

Evidence from test activities will be reviewed by IBC’s IT Oversight Committee and shared with other governance bodies, including the Financial Services Commission of Ontario (FSCO).

In August, a public testing process will begin, which will include clinical and administrative staff from health facilities as well as volunteers from the insurance industry.

Seeking Health Facility and Insurance Volunteers for Testing

HCAI is looking for volunteers who have used the HCAI system in the past.

Health care facilities that wish to be part of the August 2009 testing process are invited to contact Viivi Riis at vriis@ibc.ca. The testing will be carried out at IBC’s offices in North York, and the minimum time commitment will be half a day (either 9 a.m. to 12 p.m. or 1 p.m. to 4 p.m.).

Insurance organizations may contact Allison Brand at abrand@ibc.ca.

Rollout Schedule

The outcome of public testing will provide additional evidence that will be used to decide whether to go forward with the current reintroduction schedule of HCAI or to proceed with further remediation efforts. Test results will be shared with governance groups and FSCO. If the testing phase meets required outcomes, HCAI will commence a voluntary rollout with selected volunteers at the end of the summer of 2009.

With respect to possible future changes to the automobile insurance system, HCAI will monitor possible changes and determine with its governance groups if changes are necessary to the rollout schedule.

Important Notice for Facilities and Insurers Still Using HCAI

In order to initiate the new environment, it is necessary to disable the current HCAI system on July 31, 2009. After this date, health care facilities will not be able to use HCAI for the creation of forms, and insurers will not be able to continue to update claim and claimant information.

For healthcare facilities and insurers who have continued to utilize the old system, we encourage you to be an early volunteer on the new production system.

As part of the reintroduction, HCAI will provide education, training and a testing environment.

It is anticipated that once the new production system is initiated, the volunteer participant base will increase steadily. Enrolment will be controlled and monitored to review its effect on system performance. After a voluntary rollout period of six months, the performance of HCAI will be assessed, and when the success criteria have been met, FSCO will be asked to support the system’s reintroduction with full adoption being completed prior to the end of 2010.

February 3, 2009 - The Health Claims for Auto Insurance system (HCAI) is now in the remediation process. To get to this point, we consulted with both insurers and provider facilities to understand the business impacts which were experienced. A third party review was also commissioned to identify the elements which affected the behaviour of the system and these will be the focus of the remediation process.

Once remediation is complete, professional testers at IBC will carry out a series of acceptance tests on the system. Though IBC testers will provide an additional layer of quality assurance, IBC will also be seeking the participation of real HCAI users in the Health Care and Insurer communities to validate the system.

As part of the remediation process and to ensure that HCAI is re-introduced under the highest standards of quality control, third-party reviews will be performed at several points between now and re-launch of the system. Furthermore, HCAI will undergo stringent testing prior to re-launch in order to ensure that it will perform efficiently even with the highest possible volume of transactions.

The schedule at this time calls for testing to occur in the summer of 2009. Upon successful completion of the test phase, HCAI will be re-introduced as a pilot. Depending on the performance of the system in pilot, full roll-out is anticipated to occur sometime in 2010.

For insurers and/or health care facilities that require an environment for self-help or practice, such an environment will be made available well in advance of the full roll-out. This practice environment should be available sometime during the summer of 2009.

Regular updates will be provided at www.hcaiinfo.ca. Educational outreach will continue to be performed by Viivi Riis (Sr. Health Analyst) for the Health Care Industry and Allison Brand (Sr. Business Advisor) for Insurers.

We appreciate the continued patience of all stakeholders as the remediation plan is implemented.

December 19, 2008 - With the HCAI remediation plan now approved to move forward, 2009 promises to be a time of tremendous activity as we work hard to get the HCAI system ready for re-launch.

IBC remains strongly committed to delivering on the promise of an HCAI system that will provide the industry with all the benefits of high-quality, standardized health claims data. This can only be accomplished by pursuing a plan that follows the highest standards of quality control.

We appreciate your continued support and patience.

On behalf of the HCAI Team, I would like to wish you all the happiest of holiday seasons and a healthy and prosperous new year.

November 25, 2008 - Plans for the re-introduction of the HCAI system have been approved by the IBC Board of Directors and continue to move forward.

In order to ensure that HCAI is re-introduced only under the highest standards of quality control, third-party audits will be performed at several points as part of the remediation process, and the system will undergo stringent stress testing prior to re-launch.

For insurers and/or health care facilities that require an environment for testing and training purposes, such an environment will be made available well in advance of the re-introduction of the live system. This test environment should be available sometime during the summer of 2009.

As the re-introduction plan is put in motion (starting immediately), regular updates will be provided at www.hcaiinfo.ca. Educational outreach will continue to be performed by Viivi Riis (Sr. Health Analyst) for the Health Care Industry and Allison Brand (Sr. Business Advisor) for Insurers.

We appreciate the continued patience of all stakeholders as the re-introduction plan is implemented.

October 6, 2008 - IBC completed a thorough review of the HCAI system and related processes over the summer. The findings from this review have been used to create a re-introduction plan for the system. Before it can move forward, the plan must now be reviewed by IBC’s IT Oversight Committee and Ontario Committee, as well as the Board of Directors of IBC and HCAI Processing.

We expect to be able to share details of the re-introduction plan, including timelines, sometime in November 2008. We appreciate the patience of stakeholders who have a need for timely information about the HCAI project.

Insurers have been consulted and kept informed of the review process via IBC’s IT Oversight Committee. Health care providers have also been engaged through the summer to gain perspective and opinions on future education initiatives and re-enrollment dynamics.

Throughout the summer, IBC has continued to train insurers, providers and third-party adjusters in order to ensure a consistently high level of proficiency with OCF form completion and review. This training is ongoing, and will be beneficial to all stakeholders when the system is re-introduced.

IBC and HCAI Processing remain committed to re-introducing the HCAI system only under the highest standards of quality control.

March 24, 2008 - At this time it is too early to know how long the suspension of the HCAI Guideline will be in effect. IBC and HCAI Processing are working with FSCO on developing a new HCAI Guideline that would allow voluntary use of the system. We will update this website when there are developments on this front.

If you are a health care provider, please continue to make use of the information on this site pertaining to OCF forms, codes, etc. These resources are relevant regardless of whether you are using HCAI or other claims processes.

March 12, 2008 - Please be advised that FSCO has issued a bulletin that is posted on their website (www.fsco.gov.on.ca) that there will be temporary suspension of the Guideline effective March 12, 2008 at 4pm which will allow users to submit OCFs outside the HCAI system