PMP Manual HCAI | Page 3

Patient Management Program - HCAI Contents Additional Contact Information:............................................................................................................... 5 Health Claims for Auto Insurance (HCAI)................................................................................................. 5 Financial Services Commission of Ontario (FSCO) ................................................................................... 5 PMP HCAI Electronic Data Interchange ...............................................................................................5 Using the HCAI System ............................................................................................................................. 6 Using the PMP HCAI Interface .................................................................................................................. 6 Setup .................................................................................................................................................7 Changing your HCAI Submission Method ................................................................................................. 7 User Names and Passwords ..................................................................................................................... 8 Set Up for PMP HCAI ................................................................................................................................ 8 Assign Provider ID’s to PMP Doctors ...................................................................................................... 10 Setting Up Clinic Address Information in PMP ....................................................................................... 11 OCF Forms in PMP............................................................................................................................12 Patient Information MVA tab ................................................................................................................. 12 Creating OCF Forms for HCAI or DEC Submission .................................................................................. 14 OCF 23 New Treatment Confirmation ...............................................................................................16 Part 1 Applicant Information ........................................................................................................... 16 Part 2 Insurance Company Information .......................................................................................... 17 Part 3 Other Insurance Information ................................................................................................ 17 Part 4 Signature of Health Practitioner ........................................................................................... 18 Part 5 Injury and Sequelae Information .......................................................................................... 18 Part 6 Prior and Concurrent Conditions .......................................................................................... 19 Part 7 Barriers to Recovery .............................................................................................................. 20 Part 8 Signature of Applicant ........................................................................................................... 20 Part 9 Guideline Services ................................................................................................................. 20 Part 10 Other Health Providers ......................................................................................................... 21 Additional Comments ............................................................................................................................. 21 OCF 18 Treatment Plan ....................................................................................................................23 Part 1 Applicant Information ........................................................................................................... 23 Part 2 Insurance Company Information .......................................................................................... 24 Part 3 Other Insurance Information ................................................................................................ 25 Part 4 Signature of Health Practitioner ........................................................................................... 25 Part 5 Signature of Regulated Health Practitioner or Social Worker ............................................ 26 Part 6 Injury and Sequelae Information .......................................................................................... 26 Part 7 Prior and Concurrent Conditions .......................................................................................... 27 Part 8 Activity Limitations ................................................................................................................ 28 Part 9 Treatment Plan Goals ............................................................................................................ 28 Part 11 Health Providers .................................................................................................................... 29 Part 12 Proposed Goods and Services ..........................................................