Technology Changes in Gathering WC Data

HR Resource
May 18, 2012 — 1,714 views  
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A growing number of states are implementing Electronic Data Interchange (EDI) programs to verify and collect workers comp claims. Although EDI programs are not yet mandatory, these systems are changing the way partners, insurers and providers handle workers comp data.

In the future, high technology systems will enable electronic processing of Proof of Workers' Compensation Insurance Coverage (POC) transactions, First Report of Injury (FROI) claims and subsequent injury reports. Medical treatment processes and bill payment records will be added after initial POC and FROI systems are complete. While these programs are being implemented, most organizations will continue submitting treatment and bill pay records on paper.

The current availability of workers comp technology varies by state. These technological advances will streamline and coordinate data submission between all parties once they are in place. EDI systems will replace paper filings and make a bureaucratic nightmare easier to manage. These technology-based systems are faster, more affordable and reduce human error.

Insurers, claims administrators and self-insured employers will be able to submit data directly to workers compensation departments in their state or through third-party vendors. Advanced data collection systems reduce costs by capturing business intelligence, generating predictive analytics and enabling self-service claims.

Emerging standards for electronic workers compensation data are being developed by the International Association of Industrial Accident Boards and Commissions. This non-profit trade association represents workers compensation agencies, claim administrators, insurance adjusters and medical providers in the United States, Canada and countries around the world. The IAIABC also works with the Workers' Compensation Research Institute, the Insurance Data Management Institute and the National Academy for Social Insurance.

States are currently implementing individual EDI claims systems that conform to IAIABC standards. Online portals allow partners and providers to use web-based coverage verification services, to report injuries, to document occupational illnesses and to record the cost of claims using EDI systems that meet international standards. Once states implement EDI systems, approved trading partners can register to submit electronic workers comp data and receive reciprocal data from their state's department of labor.

These breakthroughs come at an important time for companies in the workers compensation industry when losses related to the recession are compromising the workers comp exposure base. WC carriers are currently working on dozens of initiatives that will the cut costs and save time by converting paper claims to electronic forms. Statewide EDI technology will increase efficiency across the board.

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