Health Care Facility | Insurers | Related Initiatives  

HCAI Update – HCAI 2018: The Year Ahead / January 18, 2018

Last year marked a significant milestone as HCAI celebrated its 10th anniversary. We’ve come a long way this past decade and, with your help, we will continue on this path of redevelopment and improvement in 2018.

Over the past 18 months, we’ve conducted on-site visits, consulted with user and advisory groups and conducted surveys to find out how we can make HCAI even better for you, our insurer community. 

This year HCAI has system releases scheduled to be deployed in the spring and fall.

Spring System Release 3.19 – Live April 9, 2018

We heard from you that the way organizations manage claims has changed in the past decade. The spring release will give you more flexibility in how you manage your claim and claimant records in HCAI. For the first time, you will be able to:

  • Permanently disable claim-claimants that are duplicate or created in error
  • Seamlessly transfer adjudicated documents to a different claim-claimant record in a different branch and/or child company without withdrawing the decision
  • Turn on/off set up of new claims and claimants in a particular branch to facilitate long-term branch consolidation
  • Give adjusters the option to update and deactivate (close) their own claim-claimant records in HCAI

We’ve also heard that guideline rules can sometimes be challenging for both insurers and facilities to remember. To help you out, we are also introducing links and warning messages to increase the visibility of applicable guidelines, such as:

  • Warning messages to facilities and insurers when a service provider submits an OCF-21B invoice for an OCF-18 more than once per month
  • Warning messages to facilities and insurers on the OCF-23 and OCF-21C if guideline amounts are exceeded
  • Direct links to superintendent guidelines and the FSCO service provider registry within the HCAI application

You will also see other highly requested improvements across the application that will make your HCAI experience better, including:

  • A new option to see a consolidated view of adjusters on the ‘grant access rights’ screen
  • Improvements to the OCF and claimant search screen
  • A new switch to turn on/off document submission to a particular branch to facilitate branch consolidation
  • New contact field on the Insurer Management screen for a ‘Chief Privacy Officer’
  • Updates to improve the rate at which documents are automatically matched to claimant records

Fall System Release 3.20 – Live October 1, 2018

HCAI’s Fall Release will see the delivery of HCAI’s first major user interface change since it was launched.  For the first time, adjusters and claims staff will have access to a new HCAI Dashboard that displays an adjuster’s complete worklist of plans, invoices and claimants in a format that is easy to understand.

This new, optional format will give users the ‘big picture’ view of their HCAI assignments that will assist them with prioritizing their workload as well as identifying and locating specific documents and claimants. 

Also coming in the fall, starting October 1, 2018, FSCO has confirmed that all facilities enrolled with HCAI will be required to submit Form 1 (Assessment of Attendant Care Needs) to insurers electronically via HCAI. Form 1 was first added to HCAI in December 2016 as a pilot.

Invoices for attendant care services will continue to be submitted and processed outside of the HCAI system.

Integrating Insurers

Integrating insurers should note that there will be no integration or schema changes in 2018. Integrating Insurers are encouraged to engage with internal business leads to evaluate how new application settings could impact integration.

As always, regression testing is recommended. The official testing window for Release 3.19 begins on January 29, 2018 and ends on March 2, 2018. More information with links to the test environment will be provided in a separate communication.

What’s Next?

HCAI is committed to providing insurers with details to help you prepare for system releases. The general timeline for Release 3.19 communications is below:

Activity Feb-2018 Mar-2018 Apr-2018
HCAI Update    
What’s New? Video    
Updated Learning Resources on HCAIinfo    

Keep checking HCAIinfo—HCAI’s dedicated eLearning resource site—for more updates and information throughout the year.

Please share this Year Ahead bulletin with individuals at your organization who interact with HCAI.