Scheduled Outage: The HCAI system will be unavailable from 5:00 p.m. (EDT) March 31 to 8:00 a.m. (EDT) April 3.
Scheduled Outage: The HCAI system will be unavailable from 5:00 p.m. (EDT) March 31 to 8:00 a.m. (EDT) April 3.
Health Care Facility | Insurers | Related Initiatives  

HCAI Update - Release 3.18 / May 25, 2017

Fall System Release 3.18

We couldn’t wait to share exciting updates that will be available in HCAI’s fall system release, Release 3.18, which goes live on October 2, 2017. The updates in Release 3.18 are the direct result of ongoing engagement with you, our HCAI insurer users.

Updates in Release 3.18 include:

  • Enhancements to streamline adjuster workflow
  • Improved access to information in HCAI
  • Changes to improve the flow of documents through your organization
  • Improvements to managing your organization in HCAI, including the launch of Phase 2 of the Insurer Merger Tool

What’s changing?

  1. Enhancements to streamline adjuster workflow

Add a reason code in bulk. Partial approvals are about to get a whole lot easier—starting in Release 3.18, adjusters will be able to apply a reason code to multiple line items on the OCF-18 and OCF-21B/C. Adjusters will also be able to remove a reason code from multiple line items on these forms in one click!

Stop searching for reason codes. Instead, adjusters will see a list of all codes and be able to use the ‘Series’, ‘Category’ and ‘Other’ filters to quickly narrow their selection.

Adjudicate and print right away. We’ve added a print button to the adjudication confirmation window to make it easier for adjusters to print and store a copy of the adjudicated form.

Stop confirming, just get going. We’re making it easier for adjusters to get their work done by removing many of the ‘Are you sure?’ pop-up windows from HCAI.

  1. Improved access to information in HCAI

Quickly find and review a claimant’s HCAI history. The ‘Associated Documents’ section of all forms will now offer the option to display a consolidated view of all a claimant’s plans and invoices. This view will display the total submitted and approved amounts (including amounts from archived and non-archived documents) as well as a total balance remaining to be invoiced. Alternatively, the user can choose to display a streamlined view of invoices made on a plan.

The Claimant Summary Report: more usable than ever. We know adjusters love our Claimant Summary report, which provides them with a total of goods and services paid in HCAI. That’s why we’re making it available in the more workable .csv format. Archived documents are not included in this report.

A better approach to archiving. We’re updating the system rules around document archiving so that it works better with how you do business. Starting in Release 3.18, all plans and invoices associated with a claimant will become eligible for archiving as a group one year after the last adjudication decision for that claimant. This change will not restore documents that have already been archived. Plans for automated claim-claimant archiving are on hold until further notice.

A consolidated view. You’ll soon have the option to filter your adjuster worklists by email. With the right set up, this could mean that you only see one worklist per adjuster.  To prepare for this change, organization administrators can review and update adjuster email addresses in the Insurer Management tab and in the User Management tab.

Even better OCF searching. We know the pre-populated date range on searches is a pain, so we’re removing it. When you get your results, you can expect to see them in chronological order by submission date. We’re also adding the option to search for an OCF by provider name, giving you even more search options.

  1. Changes to improve the flow of documents through your organization

Matching made easier. HCAI is simplifying the OCF matching process to make it more intuitive for staff. We’re making it easier for a user to be able to see what data elements caused the form to be unmatched. We’re also taking steps to improve the ratio of forms automatically matched to claimants in HCAI.

Transfer documents between affiliated companies. With the full launch of the merger tool, affiliated companies can choose to join together in a parent-child set up. This will allow increased ability to transfer unmatched forms between companies.

  1. Improvements to management and administration

Update your contact information with ease. The Insurer Management screen will be better organized so it’s easier to review and update contact information for your organization.

More options for merged companies. The insurer merger tool allows insurers who have undergone mergers to combine their organizations in HCAI in a parent-child set up. Details about the merger tool, including how it works and how to request it for your organization are available on HCAIinfo on our new Insurer Mergers page.

Keep an eye on integration activity. We’re making it easier for integrating insurers to monitor the use of their credentials. We are adding an Integration Activity Report to the ‘Reports’ tab that will list instances of integration requests being sent to HCAI on their behalf.

Planned HCAI system unavailability

In preparation for Release 3.18, the following system unavailability window is planned:

September 29 - October 2, 2017

  • The HCAI system will be unavailable from 5:00 p.m. (EDT) on Friday, September 29, 2017 and is expected to resume active status at 8:00 a.m. (EDT) on Monday, October 2, 2017
  • Every insurer must have all of its integration transactions successfully processed by 4:59 p.m. (EDT) Friday, September 29, 2017

What’s Next?

  • Share this update with individual(s) at your organization who interact with the HCAI system so they know what to expect this fall
  • Check out the Insurer Mergers page to see how the insurer merger tool can help your organization and contact to begin planning and preparations
  • Review and update adjuster emails Organization Administrators can review and update adjuster email addresses in Insurer Management tab (for each branch) and in the User Management tab