Health Care Facility | Insurers | Related Initiatives
Health Care Facility | Insurers | Related Initiatives  

HCAI Update: Release 3.26 Goes Live November 15, 2021 / September 15, 2021

Release 3.26, which goes live on November 15, 2021, is the final system release of this year and the changes in this release will minimally impact Health Care Facilities.

Here’s what you need to know about release 3.26:

1. Changes on Explanation of Benefits (EOB) Form

The Explanation of Benefits form (EOB), formerly known as the OCF- 9 is a statement sent to the claimant from their insurer explaining what medical treatments and/or services are partially approved or declined. This is not a mandatory form in HCAI but may be used by some insurers. The EOB can be generated in HCAI by an adjuster after recording a decision against a submitted OCF document. The adjuster provides a printed copy of the EOB to the claimant. They can also choose to submit the EOB via HCAI, which will make it available to be viewed by the facility that submitted the OCF. If an EOB has been submitted via HCAI, an icon will appear on the Adjuster Response tab in HCAI, next to the OCF type column.

As of Release 3.26 there will be a change to the online form, it currently explains details on how to file an application to the Licence Appeal Tribunal (LAT). However, changes to the process for filing an application to the LAT can happen at any time. The details explaining how to file for an application will now be replaced with a direct link to the website. Having a direct link will allow claimants to visit the website for accurate and up-to-date information on how to apply.

2. Operational Maturity and Upgrades

We continue to focus on the system’s operational maturity and providing upgrades to the HCAI application. This is conducted to ensure a smooth operation of HCAI. Ultimately, we continue to aim at maintaining a positive user experience.

3. System Outages

Two of HCAI's upcoming system unavailability windows are required to conduct scheduled maintenance for HCAI, and implement System Release 3.26.

October 1, 2021 – October 4, 2021 (SQL server upgrade)

  • The HCAI system will be unavailable from 5:00 p.m. (EDT) on Friday, October 1st, 2021, and is expected to resume active status at 8:00 a.m. (EDT) on Monday, October 4th, 2021.
  • Every Facility must have all of its transactions successfully processed by 4:59 p.m. (EDT) Friday, October 1st, 2021.

November 12, 2021 – November 15, 2021 (Release implementation)

  • The HCAI system will be unavailable from 5:00 p.m. (EST) on Friday, November 12, 2021, and is expected to resume active status at 8:00 a.m. (EST) on Monday, November 15, 2021.
  • Every Facility must have all of its transactions successfully processed by 4:59 p.m. (EST) Friday, November 12, 2021.

What’s Next?

Need a refresher on the HCAI basics? Whether you’re new to HCAI or would like to brush-up on your skills, you can now visit the new HCAI Bootcamp pages to learn at your own pace.  The videos include a recorded webinar and a demo on how to successfully create and submit a plan and invoice in HCAI.