1 Claims EDI R3 Data Warehouse Featured Functionality.

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Claims EDI R3 Data Claims EDI R3 Data Warehouse Warehouse Featured Featured

FunctionalityFunctionality

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The The DWC Claims DWC Claims EDI EDI Data Data WarehouseWarehouse reflects the raw reflects the raw data exactly as sent by the data exactly as sent by the claim administrator, with a claim administrator, with a few formatting exceptions few formatting exceptions (e.g. dates displayed in (e.g. dates displayed in readable format). readable format).

It does not imply that the It does not imply that the EDI filing was accepted and EDI filing was accepted and loaded to DWC’s accident loaded to DWC’s accident database.database.

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Maintaining Trading Partner Maintaining Trading Partner AccountsAccounts

The EDI Team establishes the The EDI Team establishes the initial data warehouse initial data warehouse administrator account for each administrator account for each Trading Partner.Trading Partner.

Afterwards, this designatedAfterwards, this designated “Account Administrator” is“Account Administrator” is be be responsible for the responsible for the maintenance of their maintenance of their company’s account. company’s account.

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Access to a Trading Partner’s Access to a Trading Partner’s warehouse account should be warehouse account should be removed when an employee no removed when an employee no longer works for your company. longer works for your company.

Please Please do not do not deletedelete the user the user from the from the warehouse … warehouse …

Do Do Not Not

DeletDeletee

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… An account should only be An account should only be deleted if it was established in deleted if it was established in error. Deleting the user will also error. Deleting the user will also delete the user’s name as the delete the user’s name as the ‘last note author’ in the ‘last note author’ in the warehouse. warehouse.

Instead, follow the instructions Instead, follow the instructions on the following slides…on the following slides…

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From the Main Menu click on From the Main Menu click on Maintain My Company’s Log Maintain My Company’s Log In Accounts.In Accounts.

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Find the user you wish to Find the user you wish to revoke and click on their revoke and click on their user id.user id.

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Place a check mark in the Place a check mark in the revoked box and a date and revoked box and a date and time revoked will be time revoked will be automatically added.automatically added.

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Click Save and Close. The user will Click Save and Close. The user will no longer have access; however, no longer have access; however, their notes will remain as the last their notes will remain as the last note author.note author.

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POP QUIZ: POP QUIZ:

If a transaction If a transaction receives a TR, receives a TR, and I don’t and I don’t understand why, understand why, what do I do what do I do next?...next?...

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ANSWER:ANSWER:

… … Login to the Login to the Data Data Warehouse and Warehouse and look up the look up the filing.filing.

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Search for an individual claim or query by Search for an individual claim or query by date ranges.date ranges.

Claims EDI Data WarehouseClaims EDI Data Warehouse

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Let’s look at a “Rejected Let’s look at a “Rejected Record”Record”Click on EE name hyperlink to see details Click on EE name hyperlink to see details

of filing. Note: You can sort on any of filing. Note: You can sort on any column header (defaults to Div Rec’d + column header (defaults to Div Rec’d + Date/Time Processed.) Date/Time Processed.)

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Caution:Caution: There may be more There may be more than one page of than one page of transactions per query. transactions per query.

Be sure to hit the ‘Next’ key Be sure to hit the ‘Next’ key to scroll to the next page, to scroll to the next page, or enter the page number or enter the page number you want to see. you want to see.

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This is a This is a test case.test case.

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This is a This is a test case.test case.

Click on Click on Errors and Errors and ProblemsProblems

There are 3 Tabs of DataThere are 3 Tabs of Data

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Errors are noted on the Errors Errors are noted on the Errors TabTab

FROI has 1 error; SROI FROI has 1 error; SROI rejected because FROI was rejected because FROI was not accepted.not accepted.

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Fatal Errors are inFatal Errors are in RedRed

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What do you do if you do not What do you do if you do not understand the error?understand the error?

Note the Element # Note the Element # (0185) and Error # (0185) and Error # (064)(064)

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Go to your copy of theGo to your copy of the Edit Edit MatrixMatrix..

Most recent version is posted Most recent version is posted on DWC’s Claims EDI webpage on DWC’s Claims EDI webpage atat http://www.myfloridacfo.com/wc/edihttp://www.myfloridacfo.com/wc/edi_clms.html_clms.html

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Click on the ‘Population Click on the ‘Population Restrictions’ tab in the Restrictions’ tab in the spreadsheet.spreadsheet.

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Find the DN # and Error # Find the DN # and Error # from the Error tab in the from the Error tab in the warehouse, in the 3warehouse, in the 3rdrd column of the Population column of the Population Rest.Rest.

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Read the details of the error Read the details of the error in the 5in the 5thth column. column.

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This error indicates that This error indicates that although Insurer Type Code although Insurer Type Code ‘S’ was sent to indicate a ‘S’ was sent to indicate a self-insured employer, DWC self-insured employer, DWC can not match the Insurer can not match the Insurer FEIN sent to the FEIN of an FEIN sent to the FEIN of an authorized self insurer. authorized self insurer.

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In this example, since the In this example, since the rejection was for an EDI rejection was for an EDI DWC-1, the Claim Admin. DWC-1, the Claim Admin. must quickly determine must quickly determine the correct self insured the correct self insured FEIN number (or FEIN number (or Insurer Type Code) and Insurer Type Code) and resubmit both the FROI resubmit both the FROI 00 and SROI IP to 00 and SROI IP to achieve a “TA” within the achieve a “TA” within the timeframes required by timeframes required by rule.rule.

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New Feature:New Feature:

Search by Search by Element/Error Element/Error

CodeCode

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The new ‘Search by The new ‘Search by Element/Error Code’ Element/Error Code’ feature was added in feature was added in response to a response to a suggestion from a suggestion from a Trading Partner. Trading Partner.

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This feature allows you This feature allows you to to research how many research how many claims have rejected (or claims have rejected (or received TA-FL) for a received TA-FL) for a particular particular DN/Error DN/Error combination. combination.

• We recommend your We recommend your query include a reasonable query include a reasonable date range to avoid locking date range to avoid locking up the system. up the system.

Search by Element/Error Search by Element/Error CodeCode

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Drop Drop Down Box Down Box with all with all DN/Error DN/Error CombinatiCombinationsons

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As with all Search Results, you As with all Search Results, you can import the results into Excel.can import the results into Excel.


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Let’s Look At Let’s Look At Another Error Another Error Example Filing Example Filing

in the in the Warehouse…Warehouse…

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The error, The error, ““BOTH FROI & SROI BOTH FROI & SROI MUST PASS EDITS TO ACCEPT MUST PASS EDITS TO ACCEPT FILINGFILING” ” means:means:

• When submitting an original When submitting an original First Report (MTC 00), you are First Report (MTC 00), you are required to submit a required to submit a corresponding SROI initial corresponding SROI initial payment or equivalent, sopayment or equivalent, so

• If either transactions fails If either transactions fails edits, both transactions will edits, both transactions will automatically fail for this automatically fail for this reason. reason.

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In this example the SROI In this example the SROI failed, so the FROI was failed, so the FROI was not accepted.not accepted.

All 001 Error All 001 Error requirements/conditions are requirements/conditions are documented in the Element documented in the Element Requirement Table. Note DN 0196.Requirement Table. Note DN 0196.

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Go to your copy of theGo to your copy of the Element Element Requirement Table. Requirement Table.

Most recent version is posted on Most recent version is posted on the Claims EDI webpage at the Claims EDI webpage at http://www.myfloridacfo.com/wc/edihttp://www.myfloridacfo.com/wc/edi_clms.html_clms.html

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Click on SROI Elements Click on SROI Elements Tab…and find DN 0196.Tab…and find DN 0196.

The The requiremenrequirement code = t code = MC, which MC, which means you means you must look must look at the SROI at the SROI Conditions Conditions TabTab

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Click on SROI Conditions Click on SROI Conditions Tab…and find DN 0196.Tab…and find DN 0196.

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Reminder:Reminder: How to research How to research errors?errors?

Error 001 – Element Requirement Error 001 – Element Requirement Table Table (including (including Conditions Tab) Error 057 – Edit Conditions Tab) Error 057 – Edit Matrix: Pop Rest and Matrix: Pop Rest and Duplicate Tab Duplicate Tab Error 063 – Edit Matrix: Pop Rest, Error 063 – Edit Matrix: Pop Rest,

Sequencing and Sequencing and Duplicate Tab Error 117 - Edit Duplicate Tab Error 117 - Edit Matrix: Pop Rest and Match Matrix: Pop Rest and Match

Data, and Duplicate Tabs Data, and Duplicate Tabs All All Other Error #’s: Pop Restrictions Other Error #’s: Pop Restrictions TabTab

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Some Errors for Error # 063 are Some Errors for Error # 063 are found in the Sequencing Tab of found in the Sequencing Tab of

the Edit Matrix.the Edit Matrix.

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Most Errors for Error # 057, and Most Errors for Error # 057, and some for #063 and 117 are found some for #063 and 117 are found in the Duplicate Processing Tab of in the Duplicate Processing Tab of the Edit Matrix.the Edit Matrix.

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Recap:Recap:

‘‘TR’ Acknowledgement Code TR’ Acknowledgement Code means your “transaction means your “transaction rejected” and must be resent. rejected” and must be resent.

• A TR can not be fixed with A TR can not be fixed with an 02 Changean 02 Change..

• At this time, please do not At this time, please do not write notes or ask questions write notes or ask questions related to related to TRTR records via the records via the warehouse; instead email warehouse; instead email [email protected]

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Reminder:Reminder:

Do Do notnot alter any factual alter any factual data or Benefit/Payment data or Benefit/Payment information in an attempt to information in an attempt to pass an edit.pass an edit.

• Thoroughly research the Thoroughly research the problem and either correct problem and either correct the inaccurate data and re-the inaccurate data and re-send the transaction, or send the transaction, or email the EDI team if you email the EDI team if you suspect our program/edit is suspect our program/edit is at fault. at fault.

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Recap:Recap:

If inaccurate data results If inaccurate data results in a CPS penalty, the in a CPS penalty, the Claim Administrator must Claim Administrator must send MTC send MTC 0202 (or other (or other appropriate MTC) to appropriate MTC) to correct the data. correct the data.

• After the MTC is After the MTC is accepted, notify the CPS accepted, notify the CPS specialist to re-evaluate specialist to re-evaluate the penalty.the penalty.

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If you already If you already investigatedinvestigated an error an error and still do not and still do not understand it, please understand it, please send an email to send an email to [email protected], rather than individual EDI team members.

This email copies This email copies all team members. all team members.

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When sending emails, When sending emails, please: please:

• Create a subject line specific Create a subject line specific to the error; do not include to the error; do not include SSN’s; SSN’s;

• Provide the JCN or your Claim Provide the JCN or your Claim number;number;

• Provide the MTC and Received Provide the MTC and Received Date; &Date; &

•Clarify which error in which Clarify which error in which table you do table you do not understandnot understand..

Note:Note: We can not address We can not address questions relative to problems in questions relative to problems in your company’s or vendor’s your company’s or vendor’s software.software.

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The Claims EDI Team The Claims EDI Team receives approximately receives approximately 50+ emails per day; 50+ emails per day; therefore, if you have not therefore, if you have not received an answer or received an answer or some acknowledgement of some acknowledgement of your emailed question your emailed question within 2 business days, within 2 business days, please resubmit. please resubmit.

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Responding to Responding to Reconciliation Reconciliation (Non-(Non-

Fatal)Fatal) Errors Errors

TA-FL’sTA-FL’s

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FL’s program also FL’s program also contains edits that contains edits that identify data considered identify data considered to be “suspect”, but to be “suspect”, but which does not warrant which does not warrant rejecting the filing. rejecting the filing.

• These edits generate These edits generate ““Reconciliation Reconciliation ErrorsErrors”.”.

Reconciliation (Non-Fatal) Reconciliation (Non-Fatal) ErrorsErrors

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‘‘Reconciliation Errors’Reconciliation Errors’ are assigned an are assigned an Acknowledgement Code of Acknowledgement Code of ‘TA’ on the AKC; ‘TA’ on the AKC;

• But displayed as But displayed as ‘TA-FL’‘TA-FL’ in the data warehouse.in the data warehouse.

• FL does not use ACK FL does not use ACK Code ‘TE’ Code ‘TE’ – Transaction – Transaction Accepted with Errors.Accepted with Errors.


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FL also does FL also does notnot accept accept MTC ‘CO’ – Correction to MTC ‘CO’ – Correction to repair/respond to non-fatal repair/respond to non-fatal errors.errors.

• Instead, non-fatal Instead, non-fatal ‘TA-FL’ errors are ‘TA-FL’ errors are addressed via the data addressed via the data warehouse in conjunction warehouse in conjunction with MTC with MTC 02 - Change02 - Change (or (or other applicable other applicable MTC/response). MTC/response).


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DWC sends email DWC sends email notification (next day) to notification (next day) to the Claim Admin. re: the the Claim Admin. re: the posting of all non-fatal posting of all non-fatal errors in the data errors in the data warehouse. warehouse.

• Claim Admin. should Claim Admin. should rectify the error on or rectify the error on or before before 21 days21 days after the after the date the error was posted date the error was posted to the data warehouse to the data warehouse (see Rule 69L-56.300(1)(see Rule 69L-56.300(1)(i), F.A.C.) (i), F.A.C.)


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TA-FL errors will not be TA-FL errors will not be identified on the ACK or in identified on the ACK or in the warehouse if the the warehouse if the transaction is rejected (TR).transaction is rejected (TR).

• Only one Ack code can Only one Ack code can be returned on the AKC.be returned on the AKC.

• Therefore, you may Therefore, you may receive a TA-FL error after receive a TA-FL error after rectifying a TR.rectifying a TR.


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How do I quickly How do I quickly find all my TA-FL find all my TA-FL error messages to error messages to see what needs to see what needs to be addressed?be addressed?


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Responding to Reconciliation ErrorsResponding to Reconciliation ErrorsOn the On the Search Search page you page you can select can select the the Processing Processing Result to Result to display display only OPEN only OPEN TA-FL TA-FL errors.errors.

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Alternatively, you can Alternatively, you can retrieve all OPEN TA-FL’s for retrieve all OPEN TA-FL’s for a specified time period) by a specified time period) by selecting selecting ‘Open Reconciliation ‘Open Reconciliation Errors Listing’Errors Listing’ under under ‘Notification Listings’.‘Notification Listings’.

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There is also aThere is also a NEW NEW FEATUREFEATURE in the in the warehouse that allows you warehouse that allows you to to generate a generate a listing of all listing of all TA-FL errorsTA-FL errors by typeby type and and thethe specific claimsspecific claims that that received those errors - received those errors -

‘‘Claims EDI (TA-FL) Errors Claims EDI (TA-FL) Errors Detail Report’…Detail Report’…


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The The Claims EDI (TA-FL) Claims EDI (TA-FL) Errors Detail ReportErrors Detail Report was added in response was added in response to a suggestion from a to a suggestion from a Trading Trading Partner.Partner.

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From the Main Menu, first From the Main Menu, first select select ‘Report Cards and ‘Report Cards and Statistical Reports’Statistical Reports’

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Then select, ‘Then select, ‘Generate TA-Generate TA-FL Detail Report’.FL Detail Report’.

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Fill in your search criteria Fill in your search criteria (Date range, office location (Date range, office location ))

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You will receive a You will receive a ‘Claims EDI ‘Claims EDI (TA-FL) Errors Detail Report’.(TA-FL) Errors Detail Report’. Results are presented in EE Results are presented in EE Name order (alpha) and then Name order (alpha) and then by TA-FL # (ascending).by TA-FL # (ascending).

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Summaries of TA-FL errors Summaries of TA-FL errors by count, form type, and by count, form type, and error # are provided at the error # are provided at the end of the report:end of the report:

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Now let’s return to Now let’s return to looking up TA-FL’s via looking up TA-FL’s via the Search screen…the Search screen…

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Responding to Reconciliation ErrorsResponding to Reconciliation Errors

On the Search Results On the Search Results screen you can see that screen you can see that there are internal there are internal reconciliation errors that reconciliation errors that are open.are open.

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If the last note author is If the last note author is blankblank or is your or is your DWC EDI LiaisonDWC EDI Liaison, , then the Claim Admin knows then the Claim Admin knows they must address the error, if they must address the error, if it is still open.it is still open.

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If the last note author is the If the last note author is the Claim AdminClaim Admin, then your DWC , then your DWC EDI Liaison will review the EDI Liaison will review the response and determine if the response and determine if the error can be closed.error can be closed.

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Responding to Responding to Reconciliation ErrorsReconciliation Errors

Reconciliation Errors are inReconciliation Errors are in YellowYellow

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Claim Admin’s should check the Claim Admin’s should check the error for which they are typing a error for which they are typing a response.response.

If there is more than 1 If there is more than 1 error, you must Select error, you must Select each error and respond each error and respond

separately.separately.


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Claim Admin’s must type a response to the Claim Admin’s must type a response to the selected error message to advise how the selected error message to advise how the error will be rectified.error will be rectified.


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DWC responseDWC response

Claim Admin responseClaim Admin response

The DWC EDI Liaison will type a The DWC EDI Liaison will type a response back to the Claim response back to the Claim Admin.Admin.


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Claim Admin responseClaim Admin response

The Claim Admin can check the “Intend The Claim Admin can check the “Intend to send 02 transaction to correct” box, to send 02 transaction to correct” box, to indicate an 02 will be sent.to indicate an 02 will be sent.


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When the error has been rectified When the error has been rectified the DWC Liaison will close the the DWC Liaison will close the error. error.

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On the Search Results screen you can see On the Search Results screen you can see the last person to respond to a message the last person to respond to a message and the status of the errors. and the status of the errors. The overall The overall error status will remain open until ALL error status will remain open until ALL errors have been addressed and closed.errors have been addressed and closed.


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Results can be saved as a text file Results can be saved as a text file and imported into a spreadsheet.and imported into a spreadsheet.

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This may make it easier to copy This may make it easier to copy and paste the JCN or your Claim and paste the JCN or your Claim Number to bring up each record in Number to bring up each record in the warehouse.the warehouse.From WordPad, copy & paste From WordPad, copy & paste

to Excelto Excel

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On the Search Results screen you On the Search Results screen you will find the JCN, your claim will find the JCN, your claim number, and many other fields as number, and many other fields as you scroll to the right. you scroll to the right.

All of this data will all save to All of this data will all save to your text file.your text file.

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Responding to Reconciliation ErrorsResponding to Reconciliation Errors If the If the same Reconciliation same Reconciliation ErrorError is generated on more is generated on more than 1 transaction for the than 1 transaction for the same claim:same claim:

• If error was fixed via MTC If error was fixed via MTC 02, you only need to 02, you only need to respond on the most recent respond on the most recent TA-FL (helpful to note if TA-FL (helpful to note if there are other identical TA-there are other identical TA-FL errors); FL errors);

• DWC will close all identical DWC will close all identical errors for earlier errors for earlier transactions. transactions.

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Reminder:Reminder:

If the Reconciliation Error If the Reconciliation Error

generated requires an MTC 02 generated requires an MTC 02

to correct data in the Benefits, to correct data in the Benefits,

Payment, ACR, OBT or Payment, ACR, OBT or

Recovery segment….Recovery segment….

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… … MTC 02 must be included in MTC 02 must be included in

the Benefits segment(s), or the Benefits segment(s), or

the changes in the segment(s) the changes in the segment(s)

will not be loaded/updated.will not be loaded/updated.

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Responding to Reconciliation ErrorsResponding to Reconciliation Errors If MTC 02 is not sent in the If MTC 02 is not sent in the

Benefits segment, the Benefits segment, the

following statement will following statement will

appear in blue above the appear in blue above the

Benefits segment in the Data Benefits segment in the Data

Warehouse… Warehouse…

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Recap:Recap:

If you send an 02 to If you send an 02 to

change the change the Payment Issue Payment Issue

DateDate of the initial of the initial

payment (a/k/a Date 1payment (a/k/a Date 1stst

Payment Mailed) …, Payment Mailed) …,

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Recap:Recap:

… … MTC 02 must be sent in the MTC 02 must be sent in the

BenefitsBenefits segment, AND segment, AND

• AA Payments Payments segment must segment must

be sent with the corrected be sent with the corrected

date. date.

•This date will This date will notnot be be

corrected from the Benefits corrected from the Benefits

segment.segment.

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Note:Note: Overpayments are no Overpayments are no longer displayed as an open longer displayed as an open ‘TA-FL’ errors in the ‘TA-FL’ errors in the warehouse (since 8/09). warehouse (since 8/09).

Filings that only have an Filings that only have an overpayment and no other overpayment and no other reconciliation error reconciliation error associated with it will reflect associated with it will reflect ‘OVER PMT’‘OVER PMT’ in the Error in the Error Status column (vs. Open) ... Status column (vs. Open) ...

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• Overpayment only Overpayment only OVER OVER PMTPMT

• O/P + non-reconciled non-O/P + non-reconciled non-fatal error fatal error OPEN OPEN

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O/P’s are currently still O/P’s are currently still posted to the ‘Errors and posted to the ‘Errors and Problem Resolution Notes’ tab, Problem Resolution Notes’ tab, but DWC does not require a but DWC does not require a response to these ‘errors’. response to these ‘errors’.

At some point in the future, At some point in the future, o/p’s will be identified in a o/p’s will be identified in a “Notification Listing’ via the “Notification Listing’ via the Main Menu.Main Menu.

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In addition to the In addition to the ‘OVER PMT’‘OVER PMT’ Error Error Status, non-fatal Status, non-fatal ‘PERM ‘PERM TOT’TOT’ errors are also errors are also posted in the posted in the warehouse. This warehouse. This classification of PT classification of PT Error Status is a fairly Error Status is a fairly recent change to the recent change to the data warehouse…data warehouse…

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……Filings with non-fatal Filings with non-fatal reconciliation errors that reconciliation errors that pertain to pertain to PT casesPT cases are are identified as identified as ‘PERM TOT’‘PERM TOT’ in in the Error Status column. the Error Status column. Sort Sort by Error Status column.by Error Status column.

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DWC’s PT Section also DWC’s PT Section also receives internal reports receives internal reports re: filing discrepancies, and re: filing discrepancies, and may solicit responses from may solicit responses from the Claim Admin. via letter the Claim Admin. via letter or email. or email.

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Report Report Cards and Cards and StatisticsStatistics

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Claim Administrators can Claim Administrators can perform a query to obtain perform a query to obtain EDI filing statistics and a EDI filing statistics and a company Report Card.company Report Card.

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Select a date range by either Select a date range by either Division Received Date or Division Received Date or Processed Date, and select a Processed Date, and select a Postal Code if you do not Postal Code if you do not want ALL claims office want ALL claims office locations included in the locations included in the results.results.

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The The Claims EDIClaims EDI Report Report CardCard has been revised to has been revised to include the include the ‘Top 5 TA-FL ‘Top 5 TA-FL Errors’Errors’ – error #, count, – error #, count, and text description (in and text description (in addition to the existing addition to the existing ‘Top 5 Reject ‘Top 5 Reject Errors’.)Errors’.)

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Rejected But Rejected But Not Not

Successfully Successfully Resubmitted Resubmitted

ListList

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Rejected Not Resubmitted Rejected Not Resubmitted ListList EDI DWC-1 equivalents EDI DWC-1 equivalents

(e.g., 00/IP, 04, etc.) that (e.g., 00/IP, 04, etc.) that reject and have not been reject and have not been successfully resubmitted successfully resubmitted will be included when this will be included when this query is run. query is run.

• Claim Admin.’s can and Claim Admin.’s can and should check this list should check this list frequently and frequently and resubmit any resubmit any outstanding rejections.outstanding rejections.

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Rejected Not Resubmitted Rejected Not Resubmitted ListList EmailEmail the EDI Team if the the EDI Team if the

EDI DWC-1 was re-filed EDI DWC-1 was re-filed (TA’d) under a different SSN (TA’d) under a different SSN or DOI from that on the or DOI from that on the Rejected Not Resubmitted Rejected Not Resubmitted List.List.

• Provide the EE’s Name, Provide the EE’s Name, File # and Div Rec’d Date File # and Div Rec’d Date for the rejected filing, so for the rejected filing, so the transaction(s) can be the transaction(s) can be excluded from the listing. excluded from the listing.

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Rejected Not Resubmitted Rejected Not Resubmitted ListListAlso notify the EDI Team Also notify the EDI Team

if an EDI DWC-1 that if an EDI DWC-1 that rejected was actually sent rejected was actually sent in error and will in error and will never be never be re-sent (e.g., Medical re-sent (e.g., Medical Only),Only), so the transaction(s) so the transaction(s) can be removed from the can be removed from the list. list.

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Rejected Not Resubmitted Rejected Not Resubmitted ListList

This data is This data is updated every updated every Saturday. Saturday.

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Claim Admin Selects Claim Admin Selects Rejected Not Rejected Not Resubmitted ListResubmitted List

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Claim Admin Selects Claim Admin Selects Rejected Not Resubmitted Rejected Not Resubmitted List List (All outstanding TR’s)(All outstanding TR’s)

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Rejected But Not Rejected But Not Resubmitted Listing now Resubmitted Listing now includes:includes:

• Incomplete EDI DWC-1 Incomplete EDI DWC-1 filings (i.e., 00 sent filings (i.e., 00 sent without the SROI).without the SROI).

•List previously only List previously only identified complete identified complete combo’s that rejected.combo’s that rejected.

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Also, the Rejected But Not Also, the Rejected But Not Resubmitted Listing has Resubmitted Listing has been revised to list an been revised to list an outstanding filing (MTC) outstanding filing (MTC) only once on the report, only once on the report, vs. listing all attempts vs. listing all attempts and multiple rejections for and multiple rejections for the same filing/MTC per the same filing/MTC per claim. claim.

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Other Other New Features New Features

in the Claims EDI in the Claims EDI Data Data WarehouseWarehouse

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Quick Search:Quick Search: If your If your query returns a listing of query returns a listing of various filings, and you various filings, and you want to drill down to just want to drill down to just the filings for one EE in the the filings for one EE in the list,list,

• Click on a BOLDED Click on a BOLDED hyperlink to obtain hyperlink to obtain historical filing historical filing information for the EE.information for the EE.

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Quick Search Quick Search Hyperlinks:Hyperlinks:

Partner ID:Partner ID: Returns all Returns all filings found for that EE filings found for that EE Name;Name;

DAN (if applicable):DAN (if applicable): Returns all filings found for Returns all filings found for that DAN;that DAN;

Claim Admin Claim #:Claim Admin Claim #: Returns all filings found for Returns all filings found for that claim #; andthat claim #; and

JCN:JCN: Returns all filings for Returns all filings for JCN.JCN.

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For example, click on the For example, click on the ‘Partner ID’ for the ‘Partner ID’ for the desired EE:desired EE:

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All filings for DOI’s, Claim #’s, All filings for DOI’s, Claim #’s, JCN’s associated with that EE JCN’s associated with that EE Name you have sent to DWC will Name you have sent to DWC will be presented.be presented.

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Scroll further to the right on the Scroll further to the right on the desired row to locate JCN desired row to locate JCN hyperlink if you want to view all hyperlink if you want to view all filings sent under a particular filings sent under a particular JCN.JCN.

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Another Another New New Feature:Feature:

Search by Filing Type:Search by Filing Type: You can now search by You can now search by MTC/Filing Type. For MTC/Filing Type. For example, you can retrieve example, you can retrieve all 00/IP filings, FROI 04 all 00/IP filings, FROI 04 filings, etc., and further filings, etc., and further narrow down the results by narrow down the results by selecting a date range and selecting a date range and processing result (e.g., processing result (e.g., Rejected).Rejected).

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On the main ‘Search” screen, On the main ‘Search” screen, click on any MTC/MTC combo click on any MTC/MTC combo from the drop down menu under from the drop down menu under “Filing Type’.“Filing Type’.

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In this example, all rejected In this example, all rejected 00/IP’s for the selected time 00/IP’s for the selected time period are presented.period are presented.

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Indicator of Last Viewed Indicator of Last Viewed RecordRecord – To help keep track – To help keep track of previously viewed of previously viewed records (such as when you records (such as when you are going down a list of are going down a list of various filings for the same various filings for the same or different EE), the EE or different EE), the EE name hyperlink will change name hyperlink will change colors (blue to purple). colors (blue to purple).

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When you return to the list, When you return to the list, the ‘purple’ will indicate the ‘purple’ will indicate which Henny Penny filing which Henny Penny filing you already viewed.you already viewed.

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SSN has been masked for SSN has been masked for security reasons (along security reasons (along with EE address, nature of with EE address, nature of injury, and accident injury, and accident description for confidential description for confidential profiles.) profiles.)

• DAN will be displayed.DAN will be displayed.

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If the filing consists of If the filing consists of both FROI and SROI MTC’s both FROI and SROI MTC’s / tabs, the data / tabs, the data warehouse view will warehouse view will default/opendefault/open to the to the SROI SROI tabtab first. first.

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Changed label in A/C/R Changed label in A/C/R segment from ‘ACR PMT’ to segment from ‘ACR PMT’ to ‘Ben Type Code’‘Ben Type Code’ for for clarification.clarification.

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Questions?Questions?

1 Claims EDI R3 Data Warehouse Featured Functionality.

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