HCAI FAQ

  • Updated

Frequently Asked Questions

While most issues will be avoided if following the HCAI Checklist closely, occasionally an error may occur that prevents a plan or invoice to submit to HCAI.

 

How to keep track of remaining treatment plans from past software?

 

1) Create an Insurance profile for the patient using a custom insurance company.
(i.e. MVA Remainder)

Enter the Default Policy Rules with a Maximum $ Per Visit amount matching the amount remaining on the active treatment plan.

Set the Coverage Reset to Do not Reset and ensure the Percent Coverage is set to 100%.

Policy_Rules.png

As this will not be invoiced, and only used for tracking, you will not need to enter any other fields (policy/id, etc)


2) Create a Treatment Plan with the remaining products/services attached as well as the insurance created in the previous step, set it to Default and manually adjust the status to read as approved.

Set_as_Approved.png

(Note, manually forcing a status is a permission set in User Types)

This treatment plan can be titled to provide a reminder. (i.e. Tracking Remaining MVA)

When booking an appointment for this patient, the treatment plan you have created will be selected by default, and using the Treatment Plan hotlinks, you are able to keep track of the remaining products or services as you invoice them.

Note: You will still be required to bill for these remaining treatment plans using either your previous software or directly on HCAI's portal.

 

 

Treatment Plan Submission Errors:

The occupation is invalid for the specified provider.
Ensure the practitioner types created for the practitioners attached to the treatment plan have the correct HCAI codes and practise type selected.
Provider is expired/invalid for specified facility.
Ensure the correct clinic is selected from the Treatment Plan Details tab and that the Practitioner has their HCAI Registration codes entered in their profile.

Specified insurer does not exists in HCAI.
Ensure the HCAI Insurance company is attached to the treatment plan and set up correctly in Settings. The HCAI Branch and Insurer numbers may need correction.

An invalid telephone number was provided. Please verify that the format is (416) 111-2222.
Ensure the patient's, and the adjuster's phone/fax number is in the correct format. You can confirm this by entering the HCAI Insurance profile and scrolling to the Adjuster's contact info. Acceptable formats are (416) 111-2222 or (416)111-2222 or 4161112222
 

This first insurance company in this treatment plan determined by the ordering field on the Insurance tab of this treatment plan, must be from a Third-Party Group that is designated as MVA.
Ensure the MVA/HCAI insurance is set to Order 1 (in the Treatment Plans' Insurance tab) while the Extended Health Benefits insurance is set to Order 2.

Once approved, you can switch the order back if you prefer to have the Extended Health insurance be selected first when booking the patient's appointment, as long as the treatment plan is also set to default.

No goods and services line items found in document
Ensure the Product/Service attached to the plan has the correct Code, Quantity of Measure, and the Covered by Insurance setting is set to 'Yes'.

 

 

HCAI Batch Billing Submission Errors:

Submission Preview does not load/blank Print Batch
Ensure all invoiced items within the batch exist in the treatment plan. Only items that exist on the plan can be invoiced to HCAI.
The auto insurance total does not equal the correct summed total.
Ensure the correct insurance(s) is/are selected in the Treatment Plan's Insurance tab. The HCAI Insurance must be first, with any Extended Health Benefits left as second and third if applicable.

The Policy Number on the plan referenced by the Plan Number does not match the Policy Number on this invoice.
Ensure the correct insurance(s) is/are selected in the Treatment Plan's Insurance tab. The HCAI Insurance must be first in order, with any Extended Health Benefits left as second and third if applicable.
Make Cheque Payable to Must be Provided

First, verify the correct clinic was selected when creating the consolidated invoice. If it was correct, but the error still appears, confirm the Cheque Payable To field on HCAI's portal (in Facility Management under the Payee heading) is not empty and that the Payee Field Editable on Invoices is set to No.

HCAI_Cheque_Payable_To_must_be_Locked.png

The Insurer field is not empty, an empty field is expected.

Ensure the payments made for the extended health benefits portion of the invoice, are indeed 'Paid By' the insurance company, and not the patient themselves.



Learn more on how to apply these payments here.
MOH Debits Total Proposed must be provided.

Insurer 1 Debits Total Proposed must be provided.

Insurer 2 Debits Total Proposed must be provided.



If you have more than once Insurance selected on the treatment plan's Insurance tab, this error is due to the consolidated batch not including split portions made out to one or more insurances. 

i.e.

A treatment plan has three insurances enabled (1 being the motor vehicle insurance, and the other two the patient's extended health benefits Green Shield and Blue Cross)

 $200 total invoice
($100 split to HCAI
$100 split to Sunlife)

The system is expecting a value for Blue Cross but not finding an invoice for the amount.

In this case you can either update the invoice split for the appropriate portion to include Blue Cross, delete the batch and reinvoice to HCAI.

Or if Blue Cross was not required (i.e. either was exhausted or no amounts paid) then you can 'disable' the insurance on the treatment plan's insurance tab and resubmit the batch.

Provider reference must be provided.
Ensure the product/service(s) being invoiced to HCAI exist on the treatment plan's approved Products/Services tab. You cannot invoice HCAI for an item that is not tied to the treatment plan.

Code provided is invalid. The OCF-21C is not approved for use with non-MIG claims. The pre-approved proposed cost must be equal to the total calculated cost.
Ensure the treatment plan's product/service(s) 'codes' that are being invoiced to HCAI are acceptable.

i.e. Any product/service being attributed towards the 'Supplementary Goods' grouping, must either have their exact product code entered as provided by HCAI here,

or if the product is outside of the typically listed products, you may use the code 'GXX99' code, along with a brief description of the item (name is fine) within the product/service's description field

or if a service, the product/service in Juvonno can be assigned the 'MIGSG' code, which will deduct from the supplementary goods approved total.
Practitioner name list has no practitioners to select from. Make sure that you have selected a clinic and selected Apply Changes and then you will see the list of practitioners.

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