What is HCAI or Health Care for Auto Insurance?
HCAI is a web-based platform used to automate the transmission of auto insurance Ontario Claim Forms (OCFs) between Health Care Facilities (HCFs) and Auto Insurers in Ontario. HCAI Tracking of plans and invoices has become a central part of the system for Therapists. HCAI is overseen and regulated by the Financial Services Regulatory Authority of Ontario (
MVA Treatment Plans
HCAI has several plan options, depending on which guideline your client falls under.
OCF-23 Treatment Confirmation Form
The OCF-23 is the form used by a Facility and/or associated Provider to inform an Insurer that treatment for an injured person will commence within the Minor Injury Guideline (MIG). If an Insurer confirms that the Claimant has a valid policy, treatment in the OCF-23 does not require prior Insurer approval.
OCF-18 Treatment and Assessment Plan
Generally, an OCF-18 treatment plan is completed after allocations under the Minor Injury Guideline have been exhausted or the injured person has been deemed to be outside of the MIG. The OCF–18 describes the cause and nature of injuries that are a direct result of the motor vehicle accident. It outlines assessments or examinations that a Health Care Facility or associated Provider feels are required for ongoing management of the Claimant’s recovery.
Form 1 or Assessment Of Attendant Care Needs
Form 1 is a mandatory form used to report the need for attendant care as the result of an automobile accident. It identifies the need for routine personal care, basic supervisory functions, and complex health/care and hygiene functions. Form 1 must be completed by an Occupational Therapist or Registered Nurse who assesses the needs of the applicant. Facilities that are enrolled with HCAI will be able to submit Form 1 to insurers electronically through HCAI using either a Case Management System (CMS) that is integrated with HCAI or the HCAI web channel. Use Skedulex Case Management System to create and submit your Form 1 and save time.
MVA Billing and HCAI Billing
HCAI has two invoices.
OCF-21B – Auto Insurance Standard Invoice
The OCF-21B is used to bill automobile Insurers for the medical and rehabilitation goods and services, assessments and examinations submitted under the OCF-18 Treatment Plan.
OCF-21C – Auto Insurance Standard Invoice
The OCF-21C is used to bill automobile Insurers for the medical and rehabilitation goods and services, and examinations delivered in the Minor Injury Guideline (for accidents on or after Sept 1, 2010).
HCAI billing is a complication process. Clinics should consider using HCAI billing software, such as Skedulex Case Management Software, to manage their clients and billings. Skedulex is fully integrated with HCAI billing, tracks plan balances and allow therapists to post their billing charges to a plan, easily and efficiently.