Insurers - Corporate Trainer - Data Entry Centre FAQs

Yes, the maximum payable for a fully completed DEC version of the OCF 18 and 22 is $63.72. Health facilities may bill a maximum of $70 for submitting the same forms via the Web or a PMS.

This is addressed in FSCO's Professional Services Guideline (PDF).

How do health facilities submitting forms via the DEC find out what the adjuster's decision is?

The DEC only offers one-way communication. There is no communication back to the facility unless a form was submitted with errors and could not be input into HCAI. For DEC-submitted forms, the adjuster will record their decision in HCAI, but must also notify the facility in the same manner as they do today (i.e. fax or mail.)

The adjuster will be able to see clearly the source of the document (WEB or DEC) displayed on each tab in the top right-hand corner of the form in the Plan or Invoice Identifier section. When the adjuster makes their adjudication decision on a DEC form, they will get an additional reminder that they must print the adjudicated form and send it to the facility by fax or mail.

Certain functions on HCAI, such as the "Need to Discuss" and "Amend" feature, are deactivated for forms that have been submitted via the DEC so the adjuster can't accidentally try to send an electronic message back to the provider who submitted the form via the DEC.

What benefits are there for the facility to enrol for electronic submission vs. using the DEC?

Providers using the electronic system will not face delays caused by form completion errors. The HCAI electronic system advises them immediately when they are inputting the form if they have made an error or if the form has been successfully received. If they use the DEC, they may have to wait up to 2 days before receiving a notice that the form had errors and must be re-submitted to the DEC.

DEC Invoicing

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