Health Care Facility | Insurers | Related Initiatives  

HCAI Update – Release 3.23: June 1, 2020 / April 7, 2020

HCAI System Release 3.23 will go live as planned on June 1, 2020. The release will bring further enhancements to streamline processes for Insurers. Some of these changes will be visible to all insurers, and some will only be visible to insurers who have migrated by June 1 to our new HCAI environment. These are highlighted in a separate section of the bulletin below.

Update Regarding Migrations amid COVID-19

During the outbreak of COVID-19, the HCAI team is able to continue our work from home and effectively support insurer migrations. As previously stated in our recent email, we do not anticipate any interruption to our operations.

A webinar version of the migration workshop was developed and will be offered to all remaining insurers who have not taken part in our educational workshops. If you have not yet attended a workshop, you will receive a webinar invitation shortly.

We are pleased to share that one of our largest insurers successfully migrated during our mandated work from home and reported a seamless transition. Initial feedback has been extremely positive and users are benefitting from custom filters and a streamlined workflow.

Enhancements Visible to All Insurers

  1. Explanation of Benefits Update
  2. HCAI’s Explanation of Benefits PDF has been updated to reflect SLASTO’s current contact information. The “In Person” section has therefore been removed.

    Insurers who use their own Explanation of Benefits should update their forms to reflect this change.

  3. Document Search Enhancements
  4. The Document Search is enhanced to include two new possible search criteria. You can now search for adjudicated documents according to the Adjudicating User or the Date Responded.

    When searching for adjudicated documents, the Target Date field will now populate with the date the response was due. As always, the target date will not display if a document’s response was withdrawn and then the document was re-adjudicated, or for invoices marked payable to the claimant.

    When downloading Documents Search results as a .CSV report, you will see a new Adjudicating User column, which indicates the name of the user who adjudicated each document.

  5. Updates to Recommended Web Browsers
  6. Access HCAI on a secure, up-to-date web browser. We recommend using Internet Explorer 11 on Windows 10, or Safari 12 on MacOS Mojave (Version 10.14). For more information about supported browsers and recommended settings, reference HCAIinfo’s Computer Requirements page.

Enhancements Visible to Migrated Insurers Only

The following changes will be visible on June 1 to insurers who have migrated.

  1. Change your Insurer Signature Settings
  2. HCAI is offering increased flexibility for the insurer’s signature section of OCF’s. Migrated insurers can now choose what kind of information will display in this section, from one of three options:

    • The claimant file owner’s name,
    • The adjudicating user’s name, or
    • The adjudicating user and the claimant file owner’s names.

    This setting can be updated by an Organization Administrator on the Insurer Management page, any time after June 1.

  3. Dashboard Updates
  4. The Dashboard’s Document Summary chart is updated to include two new bars representing Needs Assignment Plans and Needs Assignment Invoices. These will highlight documents that need to be reassigned to a new claimant file owner. As a result, team leads and administrators will have extra assurance that no documents go unassigned due to user account changes.

  5. Worklist Filter Updates
  6. We have added a new criterion for your custom worklist filters – you can now filter adjudicated documents according to the Adjudicating User.
    If you attempt to use or edit a worklist filter that is now obsolete, you will see a message indicating you can either edit the filter or delete it. For example, a filter will become obsolete if it contains a team that has been deleted.

  7. Target Dates for Adjudicated Documents
  8. When viewing adjudicated documents on your worklist, the Target Date field will now populate with the date the response was due. As always, a target date will not display if a document’s response was withdrawn, or for invoices marked payable to the claimant.

Planned HCAI System Unavailability

In preparation for Release 3.23, the following system unavailability window is planned:

Friday, May 29 – Monday, June 1

  • The HCAI system will be unavailable from 5:00 p.m. (EDT) on Friday, May 29, 2020 and is expected to resume active status at 8:00 a.m. (EDT) on Monday, June 1, 2020
  • All integrating insurers must have all of their integration transactions successfully processed by 4:59 p.m. (EDT) Friday, May 29, 2020