Health Care Facility | Insurers | Related Initiatives  

HCAI Update – HCAI 2019: The Year Ahead / January 21, 2019

In 2019, HCAI will continue to develop enhancements based on insurer feedback.  The year ahead will feature one system release, Release 3.21, which is scheduled for deployment on April 1, 2019. The remainder of the year will be focused on preparing for the next system release that will occur in February 2020 and will include important changes to the user interface, enhancing flexibility while streamlining administration of users, claims, and claimants.

System Release 3.21 – Live April 1, 2019

System Release 3.21 will be highlighted by a new feature that will facilitate user access to financial information about transactions in HCAI.

  • HCAI will introduce a new report called the Claimant Financial Summary which will provide an overview of the plans, invoices and adjudication decisions.  Managers, Claim-Claimant Administrators, and Adjusters with the Claim-Claimant Editor role will be able to easily access and download this report by clicking the Claimant Summary chart on their Dashboard. 
  • The Associated Documents section will also be updated with this financial information, to allow Adjusters to easily determine the precise amount adjudicated for goods and services, with the taxes separated. This information will be available in both the Plan View and Claimant View.
  • Additionally, facility names will be added to the Document Search results screen, allowing Adjusters to easily identify the facility providing treatment without opening specific documents.

Release 3.21 will also include maintenance updates to ensure HCAI remains current:

  • HCAI will implement the 2018 version of ICD-10-CA and CCI Codes. If your organization requires a complete set of these codes, they can be obtained directly from the Canadian Institute for Health Information (CIHI).
  • HCAI’s printed/PDF Explanation of Benefits (EOB) will be updated to reflect updated contact information for the Safety, Licensing Appeals and Standards Tribunals Ontario (SLASTO). Your organization may want to review its EOB, if using a version outside of HCAI.
  • For the safest user experience, access HCAI using a supported, up-to-date web browser. View HCAIinfo’s Computer Requirements page for more information about recommended settings.

System Release 3.22 – February 2020

Release 3.22 will be a special release, concluding the first phase of HCAI Modernization and delivering significant system improvements based on our insurer community’s feedback. Once insurers migrate to the new enhancements following release implementation, they will benefit from:

  • A newly enhanced worklist called “My Inbox” with flexible filtering options to easily view plans and invoices.
  • Customized filter options to allow quick access to the most relevant information.
  • Users will be associated directly to Claimants through a new field called Claimant File Owner, eliminating the need to create Adjuster Profiles in addition to user accounts. This will streamline user set up.
  • HCAI will introduce Claims Groups, an improved way for companies to organize claims which can allow users greater access to documents while still providing options to keep certain claim documents confidential.
  • A new Team Functionality will allow users to be assigned to a team. This will enhance filtering options, provide the opportunity to share a worklist and help prioritize actions.

How will System Release 3.22 Be Implemented?

When System Release 3.22 goes live, you will not see immediate changes to your user experience. In order to take advantage of these exciting updates, your organization must complete a migration process, and notify HCAI Insurer Support once this process has been initiated.

HCAI will provide further information in the coming months and offer hands-on workshops to equip your organization with the knowledge and resources required to ensure a smooth migration. 

Planned HCAI System Unavailability

In preparation for Release 3.21, the following system unavailability window is planned:

Friday, March 29 – Monday, April 1

  • The HCAI system will be unavailable from 5:00 p.m. (EDT) on Friday, March 29, 2019 and is expected to resume active status at 8:00 a.m. (EDT) on Monday, April 1, 2019.
  • All integrating insurers must have all of their integration transactions successfully processed by 4:59 p.m. (EDT) Friday, March 29, 2019.

What’s Next?

  • Share this HCAI Update with individuals at your organization who interact with the HCAI system.
  • Keep checking HCAIinfo – HCAI’s dedicated eLearning resource site – over the coming months for more information.