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HCAI Becomes Mandatory on February 1, 2011

ALL Ontario Health Care Facilities Will be Required to Use HCAI to Submit Ontario Claims Forms to Insurers

January 7, 2011 - Effective February 1, 2011, every health care facility and health care provider that practices in Ontario and mails or delivers any document to which the Health Claims for Auto Insurance (HCAI) September 2010 Guideline – No. 07/10 applies will be deemed to be a Participating Provider (see http://www.fsco.gov.on.ca/english/insurance/auto/HCAI.asp). This means that effective February 1, 2011, every Ontario health care facility (and every associated health care provider) that submits OCF-18s, -21s and -23s to insurers in Ontario must do so only through HCAI.

With the completion of the 2010 rollout of HCAI to known health care facilities that were part of the 2008 deployment, HCAI has processed over 1.2 million forms. It is now used by more than 18,000 individuals working within over 5,600 named health care facilities and 127 insurers.

What Does This Mean for Insurers as of February 1, 2011?

• Insurers will no longer have to refer to Financial Services Commission Ontario’s (FSCO’s) HCAI Participating Provider List.
• Insurers will not need to respond to OCF-18s, -21s and -23s that Ontario health care facilities deliver directly to them instead of through HCAI.
  • In these instances insurers are requested to contact and inform health care facilities of their obligations in connection with the HCAI system.

What Does This Mean for Health Care Facilities that are Not Yet Enrolled with HCAI?

• Effective February 1, 2011, insurers will not need to process or respond to OCF-18s, -21s and -23s from Ontario health care facilities unless they are submitted through HCAI.
• Health care facilities that have not enrolled with HCAI should do so as soon as possible.
• Instructions on how a health care facility can enrol and work within the HCAI system are located at www.hcaiinfo.ca.

Need information on how to adopt HCAI? Go to WWW.HCAIINFO.CA.