Service Provider Licensing
What is Service Provider Licensing?
Separate from the HCAI system, the Financial Services Commission of Ontario (FSCO) oversees the Ontario government’s service provider licensing (SPL) regime.
A Service Provider – as defined by FSCO for the purposes of SPL – is a business that provides specified goods or services (known as “listed expenses”) to statutory accident benefit claimants, and for which the business submits an invoice through HCAI for payment by automobile insurers.
In order to receive direct payment from an insurer, Facilities that use HCAI must have a valid FSCO service provider licence both at the time the treatment or service is performed, and when the invoice is submitted. 99% of Form volume in HCAI comes from licensed Facilities.
You can learn more about service provider licencing at FSCO’s website here.
How do I Apply for a Service Provider Licence?
Applying for a FSCO service provider licence is a separate process from your HCAI enrolment. However, you must complete your HCAI enrolment first before applying for a licence.
To apply for a service provider licence, you require certain information from HCAI. This includes your HCAI Facility Registry Number, which can be found:
- On your printed Enrolment form in the “HCAI Facility Number” field
- On the HCAI web application in the Manage > Facility Management sub-tab, under Facility Identification. (View screenshot)
Visit FSCO’s service provider licensing webpage to apply. FSCO has developed a service provider licensing guide and instructional eLearning video to aid in the application process.
How do I enter my FSCO Licence Number into my HCAI account?
This process is done automatically. The process will take approximately one business day.
Do I Need to Renew My Licence Every Year?
FSCO states that “once a licence is issued, it will continue indefinitely, as long as the licensee complies with the law, files an Annual Information Return (AIR) every year, and pays the annual regulatory fee”.
FSCO explains how to file the Annual Information Return (AIR) here.
You can view more information on fees and other requirements at FSCO’s service provider licence FAQ page.
Can I Submit an Invoice without an SPL?
Yes. In the OCF-21B and OCF-21C, Part 4 Payee Information asks “Is the payee the health care facility?”
A Facility without a service provider licence must select “No”. The Insurer may only pay the Claimant. The Claimant must additionally provide a paper print-out of the HCAI-submitted OCF to the Insurer. See Provider Support page for step-by-step information on filling out OCFs.
Can I Submit an Invoice if the Service was Provided Before I was Licensed?
Yes. In the OCF-21B and OCF-21C, Part 4 Payee Information asks “Is the payee the health care facility?”
A Facility who provided the service before being licensed must select “No”. The Insurer may only pay the Claimant. The Claimant must additionally provide a paper print-out of the HCAI-submitted OCF to the Insurer. See Provider Support page for step-by-step information on filling out OCFs.