Insurer Management
How to manage your insurer organization's information in HCAI.
In order to update your organization’s information, you must have the Organization Administrator role assigned.
Do I have the Organization Administrator role? When logged in to HCAI, Organization Administrators are able to view the Manage tab and the Insurer Management sub-tab.
Explore the Jump To menu for step-by-step instructions explaining how to perform insurer management tasks.
Update insurer contact information
It’s important to ensure your organization’s contact information, especially the phone number and email address for Contact 1,Contact 2, and Chief Privacy Officer, is always kept up-to-date in HCAI.
Contact 1 and Contact 2 are the only two individuals in your organization who receive HCAI’s information and updates via email. These two individuals play a vital role in distributing this information to others in your organization.
To update your company information, you must have the organization administrator level of access.
Click on the Manage > Insurer Management tab. The ‘Insurer Details’ screen will appear.
Update any of the editable fields in the ‘Insurer Details’ section, excluding the ‘Insurer Name’ field (View Screenshot). If you need to change your organization’s name, please review the ‘Insurer Name Changes’ section below for more information.
When you have finished updating the ‘Insurer Details’ section, press the ‘Save’ button.
Manage insurer’s signature settings
Insurers have the option to choose what name will display in the insurer's signature section of each OCF when it is adjudicated. Any modification to the setting will apply only to documents adjudicated after the setting is changed. Each child insurer may have a different signature policy if required.
You may choose from three possible signature policies:
Claimant file owner’s name: the name of the file owner assigned to the claimant at the time of adjudication. This is the default selection if the setting is not updated by the insurer.
Adjudicating user’s name: The name of the user who recorded the adjudication decision, whether or not this user is the claimant file owner.
Adjudicating user’s name “on behalf of” the claimant file owner’s name: The names of both the user who recorded the adjudication decision, and the claimant file owner. E.g. “Smith, John on behalf of Jones, Jane.” If the adjudicating user and claimant file owner are the same, their name will only appear once. E.g. “Smith, John”.
The selected information will appear in the following sections of each OCF:
OCF-18: Part 13: Signature of Insurer
OCF-23: Part 11: Signature of Insurer
OCF-21: Signature of Insurer
Form 1: Adjuster Details
Please note: When an OCF is marked “cannot be matched” or “sent to wrong insurer” the OCF’s insurer signature section will display blank.
To update the insurer’s signature settings:
Go to the Manage tab and the Insurer Management sub-tab.
If you have one or more child insurer(s), you may select an insurer the from the Insurer drop-down at the top of the page. Each child insurer may have their own signature policy.
Scroll down to the section titled “Insurer’s Signature Settings” (View screenshot)
Select your preferred option.
Click “Save”. The new setting will be reflected on all documents adjudicated from this point forward.
Insurer name changes
When an insurer decides to rename the organization, either because of a merger or rebranding, there are a few important factors to consider. Most importantly, submitting health care facilities will need to be aware of your name change so that they can continue to submit OCFs to your organization. The name you select will also appear at the top of printed Ontario Claims Forms (OCFs).
Insurance companies that would like to change their name must complete a name change form. This form binds the new legal company name to the HCAI Terms and Conditions. The display name in HCAI does not necessarily need to reflect the full legal name, but it should provide enough guidance to the submitting health care facility about which insurer to select.
Other factors to consider:
The name cannot exceed 50 characters (including spaces)
It is the responsibility of the insurer to contact every affected policyholder, current claimant and submitting health care facility to advise them of the name change
Name change process
To request a name change in HCAI:
Review and complete the ‘Insurer Name or Address Change Form’
Send the form to HCAI Insurer Support
HCAI Insurer Support will review the request and will advise the insurer if the name change is accepted
