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Enhanced Care

Enhanced care and recovery benefits

Under Enhanced Care, all British Columbians injured in a crash on or after May 1, 2021 have access to medical care and treatment needed to recover, no matter who is responsible (at fault) in the crash.

What Enhanced Care coverage means for health services

To ensure the value and effectiveness of the care and recovery available under Enhanced Care coverage, ICBC works with a wide range of health care providers, disability advocates and other stakeholders.

ICBC focuses on creating a supportive and transparent customer experience. Enhanced Care enables customers to achieve recovery through quality care and delivers the greatest value to British Columbians. ICBC has defined a series of guiding principles that influenced the design of Enhanced Care:

Fund evidence based treatment that is reasonable, necessary, and medically advisable.
Utilize function-based outcomes to support customer recovery.
Support seamless and timely access to care.
Customize the level of intervention and involvement to the unique needs of the customer.
Collaborate with health care providers to support their design and delivery of integrated care.

Below, find more information about key elements of Enhanced Care for health services.

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Early access treatment

Under Enhanced Care, ICBC supports customers in accessing early access treatments, previously known as “preauthorized treatments,” that meet their rehabilitation needs. Early access treatments are available within the first 12 weeks following a crash.

Treatments accessed within the 12-week period should be necessary for the customer's rehabilitation, with a focus on reaching functional goals and following evidence-informed best practices.

To ensure ICBC is paying the fair market rate for treatments, rates are adjusted to the Consumer Price Index. You can see the fees for your specific discipline In the ICBC fee guide for Health Care Providers on your health care provider page linked in the navigation bar.

If a customer requires additional treatments beyond the early access period, you can submit a treatment plan through the Health Care Provider Portal or the Health Care Provider Invoicing and Reporting (HCPIR) application. We also accept treatment plans via email using a pre-populated PDF form. You can learn more about treatment plans below.

Health care provider portal

The new Health Care Provider Portal provides you with a more comprehensive view of your account with ICBC so you get essential work done more quickly and easily. Health care providers can log into the authenticated portal to:

Submit invoices, reports and treatment plans with automatically populated customer information (like legal first and last name and Personal Health Number)
View and track the status of invoices submitted to ICBC
View payment history

To access the Health care provider portal, you'll need to enter a personal identification number (PIN) to set up login credentials and when logging into the portal. If you are signed up for direct deposit, your unique PIN will be sent to the email address used for direct deposit. If you aren't signed up for direct deposit, you'll receive your PIN through the mail. To sign up for direct deposit, complete the direct deposit form and submit to ICBC.

The current Health Care Provider Invoicing and Reporting (HCPIR) application is still available, giving you options for how you submit invoices and reports to ICBC.

Note: Vendors who currently have access to the HCPIR application include Acupuncturists, Chiropractors, Counsellors, Kinesiologists, Medical equipment providers, Nurses, Occupational therapists, Physiotherapists, and Psychologists, Registered massage therapists.

Treatment plans and reports

Treatment Plans

Under Enhanced Care, health care providers are required to submit a treatment plan for customers who need additional treatments or interventions beyond the early access treatments.

Treatment plans focus on the functional outcomes you anticipate customers will achieve with further treatment. Treatment plans are expected to demonstrate the direct benefit that further treatment could have on the customer's recovery without the requirement for a physician’s note. Health care providers can submit the treatment plan through the HCPIR application, the new Health Care Provider Portal, or via email using a pre-populated PDF form.

Reports

Initial reports

For crashes that occurred on or after May 1, 2021, initial reports from physiotherapists, kinesiologists and chiropractors are not required. If ICBC needs a report to make an insurance funding decision, an ICBC claim representative will contact you directly to request a progress report.

Progress reports

Progress reports (formerly called reassessment reports) are required when requested by an ICBC claim representative.

Interacting with ICBC

ICBC’s claim representatives will play a greater role in coordinating and monitoring a customer's claim, particularly when injuries are more severe and complex. This means ICBC will be proactively engaging with the customer and their care team to support recovery and introducing new ways to support collaboration between ICBC and health care providers. Together, we will learn how a customer's injuries are impacting their life, establish recovery goals and milestones, and will use the most up-to-date evidence to help support the best possible recovery.

Care Plan Meeting

A Care Plan Meeting is meant to resolve barriers, overcome challenges and realign expectations in the return to work/function plan.

With Enhanced Care, ICBC claim representatives initiate and schedule these conversations with members of the customer's care team, their employer, and the customer to align on goals, objectives and overall medical case management.

We want to encourage collaboration amongst the customer's care team and other stakeholders to enable supportive transitions, functional improvements and reaching recovery goals.

Clinical Advisory Group

The Clinical Advisory Group provides objective, evidence-informed, and timely clinical insights to ICBC claim representatives when inquiries arise during a customer's recovery.

The Clinical Advisory Group is made up of registered health professionals, including physicians and health care providers, who provide their clinical expertise to help ICBC claim representatives make informed insurance funding decisions. The role of the Clinical Advisory Group is to provide an opinion but not to make adjudicative or entitlement decisions; that remains the claim representative’s role. Members of the Clinical Advisory Group may contact health care providers directly to better understand the rationale behind treatment or care plan recommendations for a customer.

WorkSafeBC and ICBC

If a client was injured in a motor vehicle crash while they were working, this is considered a WorkSafeBC claim and their injury claim should be reported to WorkSafeBC as soon as possible. Health care providers should invoice WorkSafeBC and follow their procedures first.

In these cases, ICBC is the second payer and may fund treatment as a top-up to Regulated rates or in addition to WorkSafeBC. For example, WorkSafeBC does not fund Kinesiology but ICBC does so kinesiologists should follow ICBC procedures for treatment and invoicing.

Multiple claims

When customers have more than one motor vehicle crash, each claim will have a specific claim number and perhaps a different claim representative. The claim representative will work with health care providers to determine if there are new injuries resulting from the most recent crash, or if the new crash exacerbated injuries from a previous crash or crashes.

If there are new injuries, ask the claim representative which claim number to use for invoicing and reporting, as different benefits may apply based on the date of the original crash.

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