Revised Treatment and Assessment Plan (OCF-18) and Auto Insurance Standard Invoice (OCF-21) For Service Provider Licensing

Bulletin

No. A-06/14

Property & Casualty

-Auto

To the attention of all insurance companies licensed to transact auto insurance in Ontario

NOTE: The bulletins that are posted on this website are provided for historical reference purposes. The information in these bulletins is accurate on the date the information is published, but is subject to change and may be replaced by more recent bulletins.

An order that is made regarding a licence holder reflects a situation at a particular point in time. The status of a licence holder can change. Readers should check the current status of a person's or entity's licence on the Licensing Link section of FSCO's website. Readers may also wish to contact the person or entity directly to get additional information or clarification about the events that resulted in the order.

These bulletins may include forms that are no longer up-to-date or accurate. Readers should visit the forms section of the FSCO website, to ensure they are using the most recent version of a FSCO form.

The Financial Services Commission of Ontario (FSCO) has revised the OCF-18 – Treatment and Assessment Plan and OCF-21 – Auto Insurance Standard Invoice to accommodate Service Provider Licensing and enable more efficient processing of these forms through the Health Claims for Auto Insurance (HCAI) system.

These changes apply to documents that are delivered on or after November 1, 2014, regardless of the date of the accident to which they relate.

Revisions

The revised OCF-18 form has new fields added for the:

HCAI Facility Registry Number,
FSCO Licence Number (if applicable), and
Service Address.

In addition, a field has been added for an Applicant or Substitute Decision Maker to confirm consent to the proposed goods and services.

The revised OCF–21 has new fields added for the:

HCAI Facility Registry Number,
FSCO Licence Number (if applicable),
Service Address, and
Billing Address.

Housekeeping changes to the OCF-21 to clarify the order of payment with regards to the Ministry of Health and Long-Term Care (MOHLTC) and other insurers are also included in this form update.

It should be noted that a subsequent Bulletin will include information about these same changes to the Treatment Confirmation Form (OCF–23), which will also include updated consent language for OCF-23.

Implementation

The revised OCF-18 and OCF-21 will be effective for use beginning November 1, 2014. Earlier versions of the OCF-18 and OCF-21 are no longer approved for use on or after November 1, 2014.

Planned HCAI System Outage

The HCAI system will be updated to support these new rules.

Insurers and providers should ensure that they successfully complete and submit their forms before 5 p.m. Eastern Daylight Time (EDT) on October 31, 2014, if they are to be processed under the existing rules. The HCAI servers will be taken offline and become inaccessible at exactly 5:01 p.m. EDT on October 31, 2014. HCAI and its Data Entry Centre (DEC) will not accept any forms after 5 p.m. EDT on October 31, 2014. Any forms that are not processed by 5 p.m. EDT on October 31, 2014 will be deemed not to have been received by HCAI before November 1, 2014, and therefore will be processed under the new rules. The updated HCAI system will become available at 8 a.m. EDT on November 3, 2014. At that point, HCAI and its DEC will begin enforcing the new rules for all submissions.

How to Obtain the Revised Form

You can access the forms at FSCO's website at www.fsco.gov.on.ca.

Additional HCAI Information

Inquiries, questions and additional information on the HCAI system (e.g., enrolment, coding, technical specifications, and educational material) can be found online at: www.hcaiinfo.ca