Advantages of EDI
Electronic reporting has many distinct advantages over the paper reporting of workers compensation claims. It is an exciting concept that provides the perfect win-win opportunity for insurance carriers, employers and injured workers.
Electronic reporting saves time
It takes about six minutes for an experienced worker to key in one paper First Report of Injury. This works out to roughly 10 paper claims keyed per hour. These same claims can be processed virtually instantaneously with EDI. A carrier or self-insured employer can transmit claims immediately. There are no delays because of the post office, the weather or handling in the mail room. EDI speeds the exchange of information so that claims are reviewed more quickly and thereby better managed. This enables injured workers to receive proper care sooner, and then return to work faster.
Electronic reporting increases accuracy and the time it takes to correct information
The more frequently information is re-keyed, the greater the chance of keying errors. Under a paper-intensive system, the employer keys the information and then sends it to the carrier. The carrier in turn keys it again, and sends it to the State, where it is finally keyed a third time. Since EDI reduces the number of times information needs to be keyed it thereby also reduces the chance of keying errors. This has the net effect of increasing accuracy. A further benefit of EDI, regarding accuracy, is that errors can be corrected almost immediately. Every EDI transmission to Workers Compensation generates an electronic acknowledgement that goes back to the trading partner the same day that the transmission is loaded onto our system. These acknowledgements let the trading partner know which claims were successfully loaded, which were accepted with warnings (i.e. conditional errors) and which were rejected. The acknowledgements provide a coded reason for why a given claim received a warning or was rejected, and this allows the trading partner to make the necessary corrections and then re-transmit the claim. All of this happens much faster than it would under a paper-intensive system. Finally, if it is not readily apparent why a given claim was rejected and you cannot figure it out, the EDI Coordinator will be happy to assist you when you call or send an e-mail.
Electronic reporting improves reporting performance
EDI is a much quicker way to transmit information than a paper-intensive system, so it naturally improves your ability to meet our reporting deadlines. These are a primary concern for both the Workers Compensation Division and insurers, and the ability to meet reporting deadlines in a more timely manner helps insurers improve their performance ratings.
Electronic reporting enhances data flexibility
As an added bonus when using EDI, employers and carriers automatically build a versatile database. This allows users to access a database of claims which is rich in information. In turn, users are able to extract a wide variety of information from the data to suit their individual needs. Worker's Compensation is flexible regarding how electronic data is submitted. We currently offer three types of electronic reporting. First, flat files can be sent via Advantis, a national electronic mailbox and a system designed to handle large amounts of data. This can be accomplished through either the trading partners on-site programming or a commercial vendor. Second, we also accept EDI datasets through an ANSI translator, software that transmits the information in a standardized format using a commercial vendor. The mailbox used is either AT&T or Advantis via the State Connect product. The third method is through the internet vendor, ClaimPort.
The WC Division is open to considering requests to implement new transmission methods. The minimum requirement for such consideration is the guarantee of at least 3,000 useful MTC transactions per year. The MTCs that the WC Division considers useful are the 148 00, 01 and 04, as well as the A49 IP, S1 and FN. All requests, however, are subject to further WC Division review with respect to internal project priorities and budgetary issues.