Use this check list to ensure all these items are set up to ensure a successful submission process. Below is a check list you can follow.
Settings (Gohealth will enable this section for you)
The HCAI module must first be enabled under the Accounting page before you can use this feature.
Clinic Information
1. Go to Settings>Clinics.
2. Under the HCAI Section, enter:
a. FSCO #
b. Facility ID
c. Username
c. Password (this is not the password you log into HCAI with) Read the instructions below to create the correct Username & Password.
HCAI Username & Password Creation
1. Log into the HCAI portal.
2. Go to the Manage tab>Click the Facility Management tab.
3. Scroll down to the field that reads Practice Management System Integration and set the field to Yes.
4. PMS Vendor name is GlobalOffice (no spaces)
5. PMS Username is your clinic (no spaces or characters). Has to be unique. (Found under Facility Identification Section, Facility Name).
6. Select Save. (If you have already created a password you will not see Save you see Reset Password).
7. Select Reset Password. Record the Username and Password exactly as it's shown on the page.
8. While logged into your GoHealth system go to Settings>Clinics & Edit the clinic.
9. In the HCAI section, enter the Facility ID which can be found your HCAI portal Facility Management page.
10. Enter the Username & Password you created above, Save.
Practitioner Types
Go to Settings>Practitioner Types. Create individual Practitioner Types and enter the CODE exactly as required by HCAI for example: MT for Massage Therapist PT for Physiotherapist. Check with HCAI to confirm the code.
Practitioner Profile Set Up
1. Go to Settings, Practitioners. Open the Practitioner Profile>Profile page # must be entered. Apply Changes.
2. Practitioner Type field: Select the correct Type. Apply Changes.
3. HCAI tab: Registry ID: Enter the practitioners Registry ID #.
To locate the correct Registry ID # go to the Accounting tab>Get Facility Info. Select the clinic name, click Get Info. Scroll down the page, locate the name of the Practitioner. Beside their name to the left is their Registry ID #.
Administrator Profile Set up
1. Settings>Administrators. Open an Administrators profile, go to the Preferences tab. Set the HCAI Notifications/ Dashboard tab set to Yes.
2. Default Filter - Treatment Plans & Invoices. When you are logged in as an administration you will see an HCAI tab on your Home dashboard.
Accounting
1. Go to the Accounting link.
2. Under the Health Claims for Auto Insurance, select Module Settings.
3. Enabled: Yes.
4. Test HCAI: No.
5. Facility #: enter your facility #.
6. Enter: Username & Password, confirm Password. Save.
Sync Insurer List (GoHealth will import this list for you)
1. Go to the Accounting tab.
2. Under the Health Claims for Auto Insurance select Sync Insurer List.
Products & Service Set up
1. Hcai requires you use their service code. Under each Product & Service item you will be billing HCAI, enter the correct Code under the Code Field.
Enter the HCAI Code found on the HCAI portal for each item.
Enter the Quantity of Measure according to 15 minutes etc. if required for that item.
2. Insurance field: "Covered by Insurance" Yes.
3. Billing: Some of the Product & Services billed through HCAI are: Initial Assessment, Mig 1, Mig 2, Mig 3 & Appointment Tracking. The appointment tracker code for HCAI is SZZPR in the product & service.
Set up a product and service for each of the above appointments to get started, ensure the HCAI code is entered in the "CODE" field.
** You are required to track appointments. This product & service item is set up with a $0.00 balance. You will use the product & service item for booking/billing appointments within blocks. Create products & service item with the correct HCAI code and set the Retail price as $0.00.
Injury Codes (GoHealth will update this section for you)
1. Go to Settings>ICD Codes.
2. Select Add/Update ICD-10 Injury\Codes. This will import a list injury codes that you can enter in the ocf forms.
Insurance Set up
These are the sections the Insurance option needs to be set up and appear for the patient and treatment plan.
- Third Party Groups: Go to Settings>Third Party Groups. Create a group called MVA.
- Third Party Companies: Open 1 of the MVA insurance companies you will be billing. Ensure the MVA group is selected. There MUST be an HCAI Branch # and HCAI Insurer # in the record.
- Patient profile Insurance tab: Create a record for the Insurance companies for EHC and MVA. There must be a percentage of coverage under the Policy Rules section.
- Patient Profile Treatment Plan: Select the insurance company/s. EHC will be #1 MVA will be #2.
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