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Ontario health care providers to send claims forms through HCAI, not insurers, as of Feb. 1, 2011


January 27, 2011   by Canadian Underwriter


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Ontario health care providers will be required to submit Ontario Claims Forms 18, 23 and most 21s directly to Health Claims for Auto Insurance (HCAI), an electronic system for transmitting insurance forms, instead of to insurers, effective Feb. 1, 2011.
“To be able to do so, health care facilities or providers must first enroll with HCAI and agree to specific terms and conditions,” Ontario’s insurance regulator, the Financial Services Commission of Ontario (FSCO), says in an online bulletin. “The terms and conditions deal with confidentiality, security, liability, access and data integrity.”
FSCO notes insurers that receive OCFs 18, 21 and 23 directly from health care providers after Feb. 1, 2011 are under no legal obligation to process or otherwise respond to the forms. “However, insurers are requested to contact and inform any such participating [health care] providers of their obligations in connection with the HCAI system.”


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