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Date Updated: November 24, 1999
Contact Person: Tracy Aiello, Electronic Claim Reporting
Phone Number: (608) 266-0434

Electronic Claim Reporting

Originally Sent November 5, 1998 Updated November 24, 1999 INS 395

To: All Insurance Carriers and Self-Insured Employers

From: Gregory Krohm, Administrator

Subject: “Electronic Claim Reporting” (EDI)

Purpose: Encourage your participation with Electronic Claim Reporting.

Wisconsin is a national leader in electronic data interchange (EDI) of Worker’s Compensation claim information. The State is working closely with the International Association of Industrial Accident Boards and Commissions (IAIABC), the group which develops national EDI standards. Using innovative EDI technology, the Division has become more efficient and responsive to the needs of its customers. Over 40 percent of first reports of injury now come into the Division electronically, and approximately 7 percent of the subsequent reports. This amounts to almost 30,000 first reports and 14,000 subsequent reports a year. Wisconsin can accept EDI First Reports of Injury (WKC-12’s), first Supplementary Reports, final Supplementary Reports (WKC-13’s), and Wage Information Supplements (WKC-13A’s).

The most frequent questions carriers and self-insured employers ask are: “What’s in it for me?” and “How do I get started?” Here are some good reasons to participate:

Electronic Reporting Saves Money. Carriers are using technology to increase productivity and minimize the cost of claims handling. Substantial savings can be made by electronically keying and storing claim information into your own systems at the same time as transmitting the information to us. Wisconsin currently saves about 4000 hours per year in keying time from claims submitted via EDI. This lowers administrative costs which are paid by insurers. Additional time and money is saved with the improved accuracy of electronic reporting through edits and immediate feedback on errors.

Electronic Reporting Improves Reporting Performance. EDI improves your ability to report timely, a primary concern of the Division and insurers. EDI speeds the exchange of information so claims are reviewed more quickly and managed better.

Electronic Reporting Increases Accuracy. If information is keyed in once instead of two or three times, keying errors are reduced. Also, fatal errors can be corrected immediately. Under a paper system, the employer keys the information, then sends paper to the carrier. The carrier then keys it again and sends it to the State where it is keyed a third time. EDI reduces these steps and eliminates the chance of keying errors.

The Division monitors accuracy of EDI users and communicates fatal and conditional errors. Coding systems have been installed that provide the capability to help you resolve fatal error messages. Further, if you don’t know why the claim rejected and you can’t figure it out, the Division will assist you when you call or send an e-mail.

This is how to get started: Call the Division. We will assist you in getting a Mail Box (IBM or AT&T, Easy Link). We can help with the field layout and formatting. We have information for the EDI process, keeping tallies on repetitive errors, suggesting possible solutions for systems errors, providing support including a “technical workshop” to walk through what the technical requirements are and doing troubleshooting for trading partners.

If you have questions about EDI you can call Tracy Aiello at (608) 266-0434. Tracy's e-mail address is aielltr@dwd.state.wi.us . You can also call Mary Bothun at (608) 267-4407. Her e-mail address is bothuma@dwd.state.wi.us. Thank you for your consideration of this important initiative for streamlining the administration of worker’s compensation.

Updated February 25, 2014
Division of Worker's Compensation
Content Contact: Admin