Health Care for Auto Insurance: Ontario chiropractors, start your engines, please!

 Maria Di Danieli
February 13, 2008
Written by Maria Di Danieli
As of February 1, 2008, enrolment in Health Care for Auto Insurance (HCAI) is mandatory for all health facilities, in Ontario, that do business with auto insurers.  This means chiropractors, too. 

Using advanced data validation, the HCAI system is designed to reduce the incidence of errors in the form-submission process. This results in high-quality data on Ontario auto insurance health claims that can be used by insurers, and the provincial government, to monitor the auto insurance system. And thanks to electronic real-time submission and approval, insurers and health-care providers will have access to timely data for claims processing.

An initiative of Ontario auto insurers, HCAI was developed in consultation with the Financial Services Commission of Ontario (FSCO) and other stakeholders in the auto insurance system, including various health-care provider associations.

Submission to insurers – electronic versus paper

The HCAI is designed, primarily, to accept electronic submissions to insurers by health- care facilities.

 However, for those health-care providers who do not have access to the Internet, or who do not wish to process their forms for insurers electronically, submission of paper forms can be carried out through the HCAI Data Entry Centre, or DEC.  Facilities that choose to submit through the DEC will mail or fax their completed paper OCFs to the DEC.  The data from these forms will be entered into HCAI for electronic submission to the insurer.  Once the data is in HCAI, the adjuster will be able to clearly see that a particular form has been submitted via the DEC and will respond to the claim in the traditional way – by fax. 

Fees and Incentives

Providers are asked to note that, although paper submission to insurers via DEC is initially a free service, in time, a transcription fee will be applied.  Details about this will be made available before the fee is implemented. 

Beginning during the current HCAI rollout period, an incentive system will be in place for those who submit OCF insurance claims electronically to HCAI.  These providers will receive a premium on their forms completion fees where such fees apply.
 
Enrolling to HCAI – DEC and non-DEC

The enrolment system for HCAI DEC is distinct from that designed for those who wish to submit electronically.  Furthermore, practitioners may enrol for either electronic submission or paper submission, but not both.  If a practitioner wishes to enroll for paper submissions, and then change this status, this may be carried out by re-enrolling. 

Activation of your facility takes five business days following receipt of your completed and signed enrolment forms by HCAI Processing (or HCAI DEC). For example, if you submit your enrolment forms on February 4, 2008, you will be able to start using HCAI on February 11.

For full details on the enrolment process – DEC and non-DEC – please visit the HCAI website at www.hcaiinfo.ca

The Health Claims for Auto Insurance (HCAI) project is part of an ongoing effort to improve the delivery of health-care benefits to Ontarians injured in automobile collisions. Building on the Auto Insurance Standard Invoice, introduced in 2001, HCAI seeks to automate the exchange of standardized health claim information between health-care providers and insurance companies.

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