Skedulex is very easy to set up for Health Care for Auto Insurance (HCAI). The entire setup is done by HCAI Onboarding Team at Skedulex. Once this setup is completed, you are given your login access and have full access to your HCAI account via Skedulex. This approach saves you many hours commonly associated with doing the setup on your own (see the section on How easy is the HCAI in Skedulex).
Skedulex is fully integrated with HCAI
Skedulex is fully integrated with the HCAI system. So what does this mean for your Health Care Facility (HCF), therapist or admin support staff? Once you register and set up your HCAI facility in HCAI, you may work from Skedulex, without having to go to HCAI. For example, you may:
- Add or remove new service providers.
- Create and submit new plans.
- Check on the plan status.
- Look at adjuster responses; reason code(s) where a plan is partially or fully declined.
- Look up plan balance or line-by-line balance.
- Create and submit Form 1.
Benefits of Skedulex’s integration with HCAI
The integration of Skedulex with HCAI offers users many benefits, including time-saving, improvements in accuracy and compliance.
- The OCF plan is partially populated with information from the client file, improving accuracy while reducing the amount of data entry and time it takes to prepare the OCF.
- Skedulex scrubs the OCF before transmission to HCAI, alerting the user for missing and incomplete information, reducing decline OCFs.
- OCFs plans and invoices are stored and backup.
- OCFs can be set up with electronic signatures, reducing printing and storing.
- Simplified Injury code search saves time.
- Preparing an OCF in Skedulex is faster than HCAI, saving time.
- The use of Templates and Draft plans saves time and improves accuracy.
OCF 18/23
- Allows for posting of charges against a plan throughout the month, or billing period.
- Tracks plan balances on a line-by-line basis; thus, preventing overbilling.
- Tracks and alerts users on monthly billing.
- Alert users of plan exhaustion.
Skedulex is set up for Single or Multi-discipline and Multiple Therapists
Skedulex is set up for use in companies working in one or more health care professions and with multiple therapists. When you select the therapists from the plan screen, Skedulex automatically enters the ‘maximum hourly rates and the maximum fees for the forms payable by automobile insurers under the SABS related to the services of any of the health care profession, listed in the Guideline. If the client is deemed to be CAT designated, check the CAT box in Skedulex and the correct CAT rate will be applied to the form. You may edit these billing rates as desired.
Skedulex is built for single or multiple HCAI Locations
FSRA requires HCF to register every location where services are provided.
A Toronto-based psychology company added a second location in Brampton to facilitate its clients in Mississauga and Brampton. FSRA requires the company to register its Brampton location, register all therapists providing services from this location, and bill out all services using this location.
Multi-location billing for HCF’s not using an integrated HCAI software presents a huge challenge, noted Varman Cholan, CTO of Baylaan Technologies. “It is common to see admin staff using spreadsheets to keep track of plans, plan balances, and location billing. Imagine the recurring costs of supporting this level of duplicity. I have recently seen a situation where a company incurs 65% of its admin costs supporting 45% of its revenue.”
Skedulex is built for single or Multiple HCAI Locations. Billing is easy as the system keeps track of the therapists and locations, and the plan numbers and balances. “Managing a multi-location HCF with Skedulex Case Management Software saves time and money….and a lot of aggravation.”
Setting up HCAI accounts for facilities with more than one location can be a bit complicated. We suggest you seek professional help to do this setup.
Skedulex has the option to set up Electronic Signatures
The use of electronic signatures saves time, printing and improves compliance. Of course, strict rules govern the use of electronic signatures, especially given the history of claims. Personal Information Protection and Electronic Documents Act (PIPEDA) defines an electronic signature as “a signature that consists of one or more letters, characters, numbers or other symbols in digital form incorporated in, attached to or associated with an electronic document.”
Under the Act, a secure electronic signature must be unique to the person making the signature; the technology or process used to make the signature must be under the sole control of the person making the signature; that specific technology or process must have the capability to be used to identify the person; the electronic signature can be linked with an electronic document in a way that will allow one to determine if the document has been changed since the signature was attached to it. Typical electronic signatures use cryptographic, biometric, or digitally capture technologies.
FSRA requires an ‘electronic true copy of the OCF-21 as submitted, provided that it is in PDF format and includes a true copy of the original authorized signature on behalf of the regulated health professional, and must be prepared to give the insurer access to inspect and copy the OCF-21 in accordance with s. 46.2 of the SABS, where requested by the insurer.
How easy is the HCAI in Skedulex?
The entire setup of Skedulex with HCAI is all done by Skedulex’s Onboarding Team, making it a no-brainer for the HCF. Here are the steps to follow:
- Registered with HCAI; set your submission method to PMS: HCAI will send you a User name and Password.
Send us the following HCAI info:
- Company Name and address as registered with FSRA.
- HCAI Facility Reg. ID
- Name to which insurance payments are to be made.
- FSRA Contact Person
Changing Submission Method from PMS to Web
- Login to your HCAI Account with admin rights.
- Go to the ‘Manage’, ‘Facility Management’ sub-tab managing Your Facility
- Scroll down to HCAI Submission Method and select “Yes” to Practice Management System (PMS) Integration. Click Save.
- Send the username and password to your onboarding team.
What is HCAI?
HCAI is an online electronic system for transmitting auto insurance health claims between auto insurers and health care providers, implemented on September 1, 2010, in Ontario. HCAI (Health Claims for Auto Insurance) was developed Ontario auto insurers in consultation with the Financial Services Commission of Ontario (FSCO), health care provider associations, and other stakeholders of the auto insurance system.
The HCAI system is administered by Health Claims for Auto Insurance Processing (HCAI Processing), a not-for-profit organization. FSCO, now FSRA, a regulatory agency of the Ontario Government, oversees the billing of Auto insurance by Health Care Facilities (HCF) that treat people injured in automobile collisions. An HCF needs a service provider license from FSRA to receive direct payment from automobile insurers. The HCF submits various Ontario Claim Forms (OCFs) to insurers, who in turn, adjudicate the OCFs within set timelines.
OCF Forms
The forms used by the HCAI system includes:
- OCF-18, Treatment and Assessment Plan
- OCF-23, Treatment Confirmation Form
- OCF-21B/C, Auto Insurance Standard Invoice
- Assessment of Attendant Care Needs Form 1
Service Providers
Service providers are classified and licensed by FSRA into 4 classes:
- Sole Proprietorship
- Partnership (General and Limited)
- Corporations
- The fourth class of service providers, Unlicensed service providers, may treat accident victims but may bill their charges to the claimants or the claimant’s lawyer, who in turn, will seek reimbursement from their insurer.
Injury and service codes
The HCAI system uses three types of codes: An Injury code to classify injuries sustained and two billing codes for its billing system. These codes are all pre-loaded in Skedulex for ease of use.
Injury Codes
ICD-10 developed by the World Health Organization and ICD-10-CA developed by the Canadian Institute for Health Information (CIHI).
Billing Codes
- CCI codes developed by the Canadian Classification of Health Interventions (CIHI).
- GAP codes developed by the Insurance Bureau of Canada, automobile insurers, and health care providers.
The Year Ahead HCAI 2022 – Setup HCAI
HCAI typically has two system releases per year, and 2022 is no exception. The year ahead will include one release in the spring, one in the fall. Release 3.27 goes live on May 2nd, 2022, and Release 3.28 is scheduled to go live in October. The first release has aspects that may impact Practice Management Software (PMS) and HCAI is actively communicating with vendors to ensure they are aware of all changes. This year, HCAI will continue to focus on operational maturity and improving the application to ensure a positive user experience.
Here’s what you can look forward to in 2022:
Updates to CCI/ICD-10-CA Codes
The CCI and ICD-10-CA codes will be updated in HCAI to the 2021 version of the Canadian Institute for Health Information’s (CIHI) codes. Once Release 3.27 goes live, the updated code descriptions will be available to select on OCFs.
As a reminder, within your OCF, you can use the Code Search tool in the ‘Code’ column by clicking the blue “…” ellipsis button to open the search window. From there, you may further drill down your search, locate the code needed and click the “Add” button.
Brushing up on Your HCAI Knowledge
This year, consider adding a review of the HCAI Bootcamp resources to your New Year’s resolutions. Here you will find:
- Bootcamp Videos that cover all of the basics
- A demonstration of an OCF created and submitted via HCAI
- Pages on tips and best practices
- Easy-to-read infographics that answer your most frequently asked questions at a glance
Whether you’re an experienced HCAI user or a newly enrolled facility, the HCAI Bootcamp will equip you with the most up-to-date knowledge concerning the HCAI system.
System Outages
As usual, an HCAI outage is needed before every new system release to implement the changes. In preparation for Release 3.27, the following system unavailability window is planned:
Friday, April 29 – Monday, May 2, 2022
- The HCAI system will be unavailable from 5:00 p.m. (EDT) Friday, April 29, 2022, and is expected to resume active status at 8:00 a.m. (EDT) Monday, May 2, 2022.
- Every facility must have its transactions successfully processed by 4:59 p.m. (EDT) Friday, April 29, 2022.
Conclusion
HCAI setup can be challenging, especially if you are a multi-location facility. More, the recurring administrative costs of tracking plans can be costly. The alternative to setting up HCAI yourself is to have professionals, who know about HCAI, do the setup for you. Similarly, select software that does all the plan and balance tracking. You will be surprised to learn that the cost to set up HCAI and administer your plans would cost you less, all costs considered.
If you still have questions or comments, drop me an email at ddoobay@skedulex.com.
Setup HCAI!
