Create and Submit Treatment and Assessment Plan (OCF-18)

This article will help you create and submit a Treatment and Assessment Plan (OCF-18) to an Insurance Company via HCAI.

You can also edit and delete OCF-18s that have not yet been submitted to HCAI.

Important: To submit to HCAI, an active HCAI account must exist and a connection between your HCAI account and Universal Office must be established.

To perform the following procedures, open the Patient Manager and select a patient with an MVA case from the list on the left.

Create and Submit an OCF-18 to HCAI

1. Select a patient case, then click the Documents tab.
2. Click [New Document] on the toolbar and select OCF-18 (Latest OCF version) in the Template type drop-down list, then click Open.
   The OCF-18 editor opens.
   
   Note: You may want to clone the OCF from a predefined OCF-18 Preset or from a previous OCF-18. To do that, select Preset or Previous in the Duplicate From drop-down list, then select one from the list.
3. Verify the Date of Accident and Document Date.
4. Click the links on the left of the screen to open, review, and complete the sections of the OCF-18. See OCF-18 Sections table.
5. In Section 7, to add Service/Product, click inside an empty cell under the Item ID column and select the item from the drop-down list.
6. Add one or more providers to the table and check the PP box beside the primary provider to identify the lead therapist.
   Note: You must associate a valid provider to each 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 Service/Product table, reference the provider by choosing the respective letter.
7. 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: To avoid having HCAI validation performed before you are ready, save the OCF-18 as Draft or Created.

Search Services and Products

To quickly find and add services and products to your treatment plan, you will want to take advantage of the Search items feature.

In Section 7 (Providers & Proposed Goods/Services) of the OCF-18:

1. Click the Search items button (just above the Subtotal).
   The Search Items window opens.
   
2. Type a description of a service/product or the ID (Code) in the box at the top of the window and click Search.
   Tip: To search just by Code or just by Description, click the arrow next to Search and choose the appropriate criteria.
3. Check the box beside the item(s) you want to add to your plan, then click Add Selection.
4. Click Save & Close.

Note: The system will append added items to the end of the Selected Plan Items list. If the service or product you attempted to add already appears in the Selected Plan Items list, the system will notify you and prevent you from adding the duplicate service/product to the plan.

Calculate Plan End Date

To accurately track patient reassessment, you will want to specify a treatment plan duration as well as identify the approximate “expiry date” of the plan. The plan does not actually expire on that date, however, you will want to know if the patient completes the treatment plan as prescribed within the estimated duration.

This feature is for office use only. Other than the estimated duration in weeks, this information is not submitted to HCAI.

To help you identify the plan end date, in Section 7 (Providers & Proposed Goods/Services) of the OCF-18:

1. Enter the number of weeks in the Estimated duration of this Treatment Plan box.
2. Check the Plan start date box and choose the date when you started (or intend to start) treating patient under this plan.
3. Click Calculate plan end date.

Note: The system will calculate the plan end date based on the start date and duration you have entered, and pre-populate the Plan end date.

List Item Descriptions

When claim forms are delivered to HCAI, only the CCI codes and GAP codes for the services and products you proposed are accepted by HCAI.

The custom service descriptions that appear in the Service/Product Description column are not accepted by HCAI, and, therefore, the adjuster will see only the generic descriptions associated with the CCI/GAP codes connected to the proposed services.

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 Proposed Goods and Services page of the OCF-18:

1. On the Providers & Proposed Goods/Services page of the OCF-18, click List item descriptions (below the Services/Products table).
2. On the Additional Comments page of the OCF-18, you will now see a list of the custom service descriptions for the plan.

Preview and Print an OCF-18

1. While in OCF-18 editor, click Preview.
2. In the OCF-18 preview, click [Print] on the toolbar.
3. Choose a printer from the list, then click Print.

Tip: While in OCF-18 preview, you may also export the document to PDF by clicking [Export to PDF] on the toolbar.

Connect to Tracking Workflow

Workflows help you with tracking and are particularly useful for assessments. To link a treatment plan to a predefined workflow, choose the Tracking Type and Category located in the upper left of the OCF-18 (right below the Plan Start/End dates).

Save as Preset

You may save a completed treatment plan as a preset.

1. After completing the pages of the OCF-18 as described above, click the arrow next to Save As and then click Preset.
2. Enter a descriptive name for the preset in the Preset Name field.
3. Click Save & Close.

View Log

The Document Log captures the state changes of the treatment plan from the moment it was created until the adjuster response via HCAI. Every log record is time-stamped and identified with a status.

To open the Document Log, open an existing OCF-18, then click View Log (top right of the screen).

The treatment plan will acquire an HCAI document number once it has been successfully delivered to HCAI.

To copy the HCAI document number to the clipboard for use elsewhere:

1. Select the number shown in the bottom left of the Document Log window.
2. Use Ctrl+C shortcut to copy.

To preview and print the log, click Preview on the bottom-right of the Document Log window. Click [Print] on the toolbar.

Preview EOB

The Explanation of Benefits (EOB) is used by adjusters when they choose to provide additional details for declined (not approved) and partially approved claims. Thus, not every OCF-18 will have a response with an EOB attached.

To preview an EOB, open an OCF-18 with EOB response, then click Preview EOB (top right of the form).

Edit an OCF-18

Note: This cannot be done for an OCF-18 that has been submitted to HCAI.

1. On the Documents tab, double-click on an OCF-18.
2. Make changes to the treatment plan, then click Save & Close.

Delete an OCF-18

Note: You may not delete treatment plans that have been submitted to HCAI. Also, you are required to enter user password and have appropriate permissions to delete documents.

1. On the Documents tab, select a treatment plan, then click [Delete Document] on the toolbar.
2. Click Yes when prompted.

OCF-18 Sections