The coming year will introduce significant enhancements to HCAI as the highly-anticipated Attendant Care Services Invoice (ACSI) is added to the system along with other insurer-requested updates, security enhancements and maturity items. Two system releases will take place in 2025, in the spring and fall. We are also pleased to introduce you to a redesigned HCAIinfo, HCAI’s information resource website, as well as the new HCAI Data Retention (HDR) system, a valuable tool for research and analysis purposes. This bulletin provides high-level details about all of these exciting upcoming enhancements.
Welcome to the new HCAIinfo
HCAIinfo.ca has been redeveloped with a modernized design to improve your user experience. This was timed to become available prior to the addition of the new ACSI form to HCAI in order to make training material and other information easy to locate and use. We invite you to explore the new website and take note of the following improvements:
An easy-to-navigate portal contain comprehensive information geared specifically toward Insurers.
The new and optimized search functionality will make answering your HCAI questions easier than ever.
The website allows you to choose how you learn, with features such as eLearning videos, quick links, extensive user manuals, and step-by-step text instructions explaining HCAI functionality.
Stay up to date with HCAI enhancements and business developments directly on the homepage by viewing the Recent News Spotlight.
The launch of the site prior to implementation of the new ACSI means you will soon have access to training material in this new, user friendly format.
Introducing the HCAI Data Retention (HDR) System
We are pleased to announce that the HCAI Data Retention (HDR) System will be launched in Q1 2025. The system, once launched, will provide insurers with comprehensive data at the industry level based on anonymized data from OCFs processed through HCAI.
It will provide comprehensive data that can be used to understand patterns such as what treatments were proposed and what adjudication decisions were made. It can also provide trends on injuries, costs and type of treatments.
Business-sensitive information such as insurance company, health care facility and provider information will not be included.
Insurers will need to use their own tools to conduct analysis
More information on this will be provided in early 2025.
HCAI System Release 3.33 – Live May 12, 2025
This spring, users can look forward to the following HCAI enhancements:
Introducing the Attendant Care Services Invoice
As was announced in October’s HCAI Update Bulletin, the Financial Services Regulatory Authority of Ontario (FSRA) has approved the introduction of the Attendant Care Services Invoice (ACSI) into the HCAI system on a pilot basis.
The ACSI will serve as a standardized invoice used to bill for approved services listed on the Assessment of Attendant Care Needs (also known as Form 1). The introduction of the ACSI will benefit business processes by offering a seamless invoicing experience.
Typically services on the ACSI are delivered by in-home personal support companies. A new provider profession, Personal Support Worker, is being added to HCAI for this purpose.
Initially, the ACSI will be introduced to the HCAI system on a voluntary pilot basis for at least one year. Participating health care facilities will be able to submit the ACSI to any Ontario auto insurer enrolled in HCAI. ACSI submissions will follow the existing billing procedures and Service Provider Licensing rules as outlined in the HCAI Guideline.
Detailed training material explaining step-by-step how to review and adjudicate the ACSI will be available on HCAI’s information resource website, HCAIinfo.ca, when the new form is released.
Explanation of Benefits redevelopment
HCAI is enhancing the Explanation of Benefits (EOB) for the OCF-21B, -21C, and Form 1 by redeveloping this form in a new framework, to align with the recent redevelopment of other forms in HCAI.
There will be no functional changes to the form’s workflow. The visible changes are largely cosmetic in nature to make for a more efficient user experience, and improve things like text alignment, spacing, and the consistency of error messages.
Insurers who believe they may be impacted by the internal framework redevelopment, can test the EOB when the test environment becomes available. Information about the test environment will be distributed to integrating insurers in the coming months.
Please note, HCAI communications are intended to provide details about user-facing changes on the HCAI web application. During release development, further internal changes may be applied to any OCF for consistency and other purposes which would not impact web users’ experience. The test environment will be available prior to the release going live for any required testing.
The ability to adjudicate invoices via integration
A new integration functionality will be introduced to allow insurers to submit or withdraw adjudication decisions for invoices (OCF-21B and OCF21-C) via the integration channel. This will allow integrating insurers to automate and submit decisions for invoices that are adjudicated in their own systems. However, insurers can continue to submit decisions via the web channel if they choose.
Insurers who are not currently integrated with HCAI but who are interested in having their technical teams explore this capability, are invited to visit HCAIinfo’s HCAI Integration page to learn more about integration, how to get started, and how to reach out for support.
Insurers who are already integrated received detailed information in the Release 3.33 Integration Bulletin distributed on November 28. 2024.
Important information for integrating insurers
System Release 3.33 will be an integration-impacting release. New integration functionalities will be introduced, including the ability to retrieve the new ACSI and ACSI EOB documents using the All-Data Extract, and to send or withdraw adjudication decisions for invoices via the integration channel.
The Release 3.33 Integration Bulletin was distributed to integrating insurers on November 28. Please review this email for details about the integration enhancements included in the release as well as testing information.
System Release 3.34 – Fall 2025
System Release 3.34 is planned to go live in the fall and is not expected to have integration impact. More information about enhancements and the system unavailability window will be communicated throughout the year.
Other important reminders
This is a reminder that as part of the ongoing maturity of the HCAI system, data retention requirements have been defined.
Claims-claimants and all associated documents will become candidates for deletion from HCAI seven years after they have been deactivated by the insurer.
This is a longer-term project with ample lead-time being provided to enable insurers to prepare if necessary. The actual deletion of data will not start before mid-2025.
You will continue to receive communications about this topic as more details become available.
What’s next?
Share this HCAI Update with individuals at your organization who interact with the HCAI system.
Explore the modernized HCAIinfo today to review our step-by-step training resources and find all the answers you need.
