This article will help you create and submit OCF-21 version B and C invoices. Both forms have the same cover page, however the subsequent pages for each version are different.
To perform the following procedures, open the Patient Manager and select a patient with an MVA case. Then, open a patient case and select the Account Activity tab. By default, the Invoices & Payments tab opens.
Create an OCF-21B Without Treatment Plan
- Click the arrow next to [New Invoice/Payment/Refund] on the toolbar, then select New Invoice.
- From the Template type drop-down list, choose the OCF-21 B (latest version), then click Open.
The first page of the editor opens, pre-populated with the patient and case information entered in the system.
- Navigating through the pages on your left to complete the form. Once completed, click Next on top-right.
- Add billing items using one of the following options:
- Under the Provider Treatment Records, check the charges you want to include in the invoice or check the Select All box. Click Transfer Selection. To filter the list, select a date range using the From and To dates. All unbilled charges for these dates are listed.
- With View Calendar checked, select the Activity and Provider, then double-click on the calendar date to add a billing item (e.g., in case you don’t use Appointment Book or forgot to add a charge).
- With View Calendar unchecked, select the Activity, and double-click on the appointment. To filter the list, select a date range using the From and To dates.
Tip: You can filter the list of appointments by status; click the arrow button next to the date ranges. - Click inside an empty cell under the Item ID column and select the billing item from the drop-down list.
Note: You must associate a valid provider to each billing item. In the Provider Reference table on top, click inside an empty cell under the Provider column and select one from the drop-down list. Then, under the PR column in the Billing Items table, reference the provider by choosing the respective letter.
- Complete any optional details as follows:
- Enter the amounts that have or will be paid by other insurers; these will be deducted from the invoice total. In addition, you can specify other types of services and the amounts in the blank cells.
- Add a Prior Balance, Payment Received, or Overdue Amount under the Account Activity section.
- To accurately communicate to the insurer about the services that are being billed for, use the List item descriptions button to append Service/Product description to the Additional Comments page of the invoice.
- Click Save & Close or click the arrow next to Save As and select HCAI Compliant (this will check the form for errors).
Create an OCF-21B by Treatment Plan
- Click the arrow next to [New Invoice/Payment/Refund] on the toolbar, then select New Invoice.
- From the Template type list, choose the OCF-21 B (latest version), then click Open.
The first page of the editor opens, pre-populated with patient and information entered in the system. - Select a treatment plan from the Plan Type drop-down list.
- Complete the form, navigating through the pages on your left. Once completed, click Next on top-right.
- Add billing items using one of the following options:
- Under the Provider Treatment Records, check the charges you want to include in the invoice or check the Select All box. To filter the list, simply select a date range using the From and To dates. All unbilled charges for the patient to date are listed. Click Transfer Selection.
Note: The items will appear under the Provider Treatment Records only if you have unbilled charges per selected Treatment Confirmation Form (OCF-18).
Tip: Under the Provider Treatment Records, you can filter by Plan or All charges by clicking the arrow button next to the date ranges. - To add charges by date or visit, double-click the “…” in the column between Service Date and RUnits. Select a service from the Service/Product drop-down list, then double-click on a date or match it with existing appointment and click Transfer Selection.
Tip: You can filter the list of appointments by status; click the arrow button next to the date ranges.
Note: In the Proposed/Approved Summary table you can see the remaining quantity (RQty) change as you double click on the calendar.
- Under the Provider Treatment Records, check the charges you want to include in the invoice or check the Select All box. To filter the list, simply select a date range using the From and To dates. All unbilled charges for the patient to date are listed. Click Transfer Selection.
- Follow steps 5-6 in the Create an OCF-21B Without Treatment Plan heading above.
Create an OCF-21C
Note: The OCF-21C can be completed by a submitted Treatment Confirmation Form (OCF-23).
- Click the arrow next to [New Invoice/Payment/Refund] on the toolbar, then select New Invoice.
- From the Template type list, choose the OCF-21 C (latest version), then click Open.
The first page of the editor opens pre-populated with information entered in the system. - Select a treatment confirmation form (OCF-23) from the Plan Type drop-down list.
- Navigate through the pages on your left and complete the form. Once completed, click Next on top-right.
- Add services and products following one of these options:
- Under the Provider Treatment Records, check the Service/Product you want to include in the invoice or check the Select All box. Click Transfer Selection. To filter the list, select a date range using the From and To dates. All unbilled Services/Products are listed for the selected duration.
Note: The items will appear under the Provider Treatment Records only if you have unbilled charges per selected Treatment Confirmation Form (OCF-23).
Tip: Under the Provider Treatment Records, you can filter by Plan or All charges by clicking the arrow button next to the date ranges. - With View Calendar checked, select the Activity and Provider, then double-click on the calendar date (e.g., in case you don’t use Appointment Book or forgot to add a charge).
- With View Calendar unchecked, select an activity and double-click on an appointment. To filter the list, select a date range using the From and To dates.
Tip: You can filter the list of appointments by status; click the arrow button next to the date ranges. - Click inside an empty cell under the Item ID column and select the Service/Product from the drop-down list.
Note: You must associate a valid provider to each Service/Product. In the Provider Reference table on top, click inside an empty cell under the Provider column and select one from the drop-down list. Then, under the PR column in the Service/Product table, reference the provider by choosing the respective letter.
- Under the Provider Treatment Records, check the Service/Product you want to include in the invoice or check the Select All box. Click Transfer Selection. To filter the list, select a date range using the From and To dates. All unbilled Services/Products are listed for the selected duration.
- Once completed, click Next on the top-right corner.
- Add MIG Blocks that you want to invoice. Click inside an empty cell under the Item ID column and select the Block from the drop-down list.
- Change the First Service Date to reflect the initial date of service provided within each block.
- Associate one or more providers per Block. Double-click an empty cell under Block Providers column. Check the box under the V column next to provider(s) who participated in the Block, then identify a Primary Provider by checking the box under PP column. Repeat for each Block.
- Complete any optional details as follows:
- Enter the amounts that have or will be paid by other insurers; these will be deducted from the invoice total. In addition, you can specify other types of services and the amounts in the blank cells.
- Add a Prior Balance, Payment Received, or Overdue Amount under the Account Activity section.
- To accurately communicate to the insurer about the services that are being billed for, use the List item descriptions button to append Service/Product description to the Additional Comments page of the invoice.
Note: For accidents with the date of loss prior to September 1, 2010, you may specify additional services in the Other Reimbursable Goods and Services table.
- Click Save & Close.
- Choose Created in the Select Document Status prompt, then click Save & Close.
Note: The option to save as HCAI Compliant will validate every detail of the form against HCAI business rules before storing the document.
Submit to HCAI
- Open a draft invoice or create a new one.
- Click Submit & Close.
Note: When requested to submit, the system will validate every detail of the form against HCAI business rules before submitting the document. In case any piece of information fails validation the system will not submit and instead highlight the fields that require your attention.
Tip: As per FSCO guidelines, a treating provider may submit an OCF-21 for services on approved or partially approved plan not more than once per calendar month. When attempted to submit a second invoice per calendar month for the same patient file, the system will prompt a warning. See SABS Invoice Submissions: Every 30 Calendar Days or Calendar Month? article.
Change Invoice Status
In Universal Office, a Status reflects the current state of a document. Right-click on an invoice, select Invoice Status and choose Created or Sent.
In such cases as where you want to fix a denied invoice and resubmit, you have the option to change the HCAI Status for submitted OCF-21s. You will require administrator’s password to change HCAI Status. You may change the HCAI Status to one of the following:
- Approved
- Delivery Failed
- HCAI Compliant – validated against HCAI business rules and ready for submission
- Information Error(s) – occur as a result of the rejection of a claim form by HCAI
- Not Approved
- Partially Approved
- Pending (retired and no longer available)
- Successfully Delivered – the document was successfully accepted by HCAI
Edit an OCF-21
Note: You may edit OCF-21 invoices in either Created or HCAI Compliant statuses only.
- Double-click on an OCF-21 (or select one and click [Edit Invoice] on the toolbar).
- Make changes, then click Save & Close.
Tip: Click the arrow next to Save As and select HCAI Compliant (this will validate every detail of the form against HCAI business rules before storing the document).
Delete an OCF-21
Note: You are required to enter user password and have appropriate permissions in order to delete the invoice. Also, you can only delete an invoice that has not yet been sent.
- Select an OCF-21.
- Click [Delete] on the toolbar.
- Click Yes when prompted.