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 ..........................................................