HCAI: Creating OCF-18

The OCF-18 describes the cause and nature of injuries that are a direct result of the motor vehicle accident. It outlines assessments or examinations that a Health Care Facility or Associated Provider feels are required for ongoing management of the Claimant's recovery.

If you are getting an e-claim agent error, please refer here for assistance. 

• Open Client Folder
• Click Records Tab
• Select Treatment Plan
• Click Payers Tab (below)
• Right-click and select Create OCF-18

• Fill out the first few pages as you see fit
• Select Treatment tab
• Select Code
• Fee should auto-populate
• Measure should auto-populate (HR)
• Select Provider from the drop down menu or you can utilize the magnifying glass to search for the provider

• Complete:
• Estimated Duration In Weeks
• Number of Visits Already Provided
• Estimated Amount From Insurer 1
• Estimated Amount From Insurer 2
• Click OK

The OCF will sit in the payer window with a blue lightening bolt until you're ready to submit. If you need to add any information to the OCF you are now able to edit the OCF! To do this, right-click on the existing OCF and select "Edit":

You are also able to delete any OCF's by following the same steps as above. When you are ready to submit to the insurance company you can:

• Right-click OCF-18
• Click Submit

The status of the OCF-18 should be a lightning bolt. Once HCAI has processed this and responded it will change to either a "D" for denied or "A" for approved.

If you notice any errors appearing, click here for our most common errors and how to fix them. 

If you have any legislation questions, please visit the HCAI website here.