Subject Numbers Regarding Health Provider Authorizations

September 28, 2012

In March 2012, the New York Workers’ Compensation Board (Board) announced the implementation of the IAIABC Claims EDI Release 3.0 standard for the submission of claims data (eClaims). The Board will publish the final version of its Requirement tables in October 2012. The electronic filing of claims data will be implemented in phases, beginning in spring 2013, and will provide timely, accurate, and credible electronic reporting.

Training Updates

The Board is conducting a series of important eClaims training events to prepare the business and technical staff of all Claim Administrators (Insurers, TPAs, Self-Insured Employers) for this significant change.

The first in a series of eClaims training courses is now available on the Board’s website. Both business and IT staff should complete the free prerequisite Course 101: Introduction to NYS eClaims using IAIABC Claims EDI Release 3.0

As outlined below, the Board will conduct on-site advanced eClaims training at three locations beginning November 2012. The training session at each location will be a full-day event comprised of both the business (201) and technical (301) courses in the series. This material is critical to preparing Claim Administrators for the eClaims mandate. The Board strongly encourages all participants to plan to attend the full-day session to completely understand their reporting responsibilities.

NYS WCB eClaims Business (201) and Technical (301) Training

Course 201: focuses on business processes impacted by the eClaims mandate
Course 301: focuses on technical requirements for eClaims submission

The combined 201/301 Course on-site training schedule for the following dates and locations is:

• November 5, 2012--New York State Insurance Fund, 100 Chestnut Street, Rochester, NY 14604
• November 13, 2012--New York State Insurance Fund, 199 Church Street, New York, NY 10007
• November 14, 2012--New York Workers' Compensation Board, 328 State Street, Schenectady, NY 12305

Registration for the 201/301 combined course is required. Early registration is strongly recommended as capacity in the training locations is limited. For information on class times and other registration information please see NYS WCB eClaims Business (201) and Technical (301) Training.

Prior to participating in the above training, business and technical staff should become familiar with the draft NY Requirement Tables, Quick Code Reference List, and MTC filing instructions, all of which are located on the eClaims section of the Board’s website. These documents are key artifacts and familiarity with them is a prerequisite to successful participation in the 201/301 course training curriculum.

Stakeholders should also obtain a copy of the IAIABC Claims Release 3.0 Implementation Guide from the IAIABC website. A fee for the manual is charged to non-members.

For more information on the IAIABC Claims EDI Release 3.0 standard, please visit the EDI Implementation Guide section of the IAIABC website at: www.iaiabc.org . Questions related to this announcement can be directed to: eClaims@wcb.ny.gov. As the Board publishes more information regarding this mandate, it will be posted on our eClaims web page.