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What is HCAI?
Health Claims for Auto Insurance (HCAI) is an electronic system for transmitting specific Ontario auto insurance health claims forms between insurers and health care providers. Development of the system was initiated as a way to collect accurate and timely data to help insurers and government better manage med rehab expenditures in the auto insurance system.
HCAI is an initiative of Ontario auto insurers, who have worked closely with the Financial Services Commission of Ontario (FSCO), the Ontario Ministry of Finance and health care provider associations to develop the system.
When the system is fully rolled out across the province, certain transactions that today are processed by sending paper forms by mail will be processed exclusively through the HCAI system. Specifically, Ontario Claim Forms (OCFs) 18 (Treatment Plan), 22 (Application for Approval of an Assessment of Examination), 23 (Pre-approved Framework Treatment Confirmation) and 21 (Standard Invoice) will be sent by health care facilities/providers to insurers via HCAI. Insurers will also record their decisions on these forms in HCAI, where health care facility staff will be able to view them.
In addition to providing the reliable data that is essential to effectively managing costs (and consequently, auto insurance premiums), HCAI offers a number of other benefits for those who use it.
- Insurers will receive more accurate and more complete data to assist in adjudicating claims
- Health care facilities/providers will expend less time and resources managing insurance forms
- All Ontarians will benefit from a more efficient auto insurance system
The HCAI system is administered by Health Claims for Auto Insurance Processing (HCAI Processing), a not-for-profit organization.
If you work for an insurer, your job may be affected by the implementation of HCAI. In order to get information on how HCAI affects you, please click on the role below that most accurately describes you.
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