WCIS eNews No. 81
November 3, 2010

WCIS reports for claims administrator review

The Division of Workers’ Compensation (DWC) is mailing letters to claims administrators at over 400 audit locations containing two sets of reports: (1) timeliness of indemnity payments for claims reported to the WCIS and (2) comparisons of claim counts received by the WCIS with those received by DWC’s Audit Unit in its Annual Report of Inventory (ARI). These reports cover claims reported to claims administrators in 2008 and 2009.

The timeliness reports were calculated using the date disability began and the date of the initial indemnity payment. Reports were not prepared for claims administrators who did not report these data elements to WCIS. Statewide reports for timeliness of payments are posted online in Table 15 at http://www.dir.ca.gov/dwc/wcis/WCIS_Reports.html.     

To compare ARI claim counts with WCIS counts, DWC researchers matched claim administrator Federal Employer Identification Numbers (FEINs) to audit locations. DWC then aggregated the claims submitted electronically to the California WCIS for all audit locations. DWC was able to match most claims reported to the WCIS to an audit location. For claims administrators with multiple audit locations, one report with data aggregated for all locations will be sent to each location. 

The DWC intends to further refine the reports based on input from claims administrators. If any assignments of FEINs and/or grouping of audit locations are incorrect, please inform DWC by emailing your WCIS electronic data interchange (EDI) contact person by Dec. 1, 2010. Where changes are made, revised reports will be sent out for review. Following this input process, the analysis will be finalized.

WCIS trading partner contacts:

Johnny Lee
email: jblee@dir.ca.gov
phone: 510-286-6772
fax: 510-286-6862
Trading Partner Letters A, I-L, S-V, Z

Elisema Cantu
email: ecantu@dir.ca.gov
phone: 510-286-6763
fax: 510-286-6862
Trading Partner Letters B, D-F, N, O, W-Y

Kenneth Kong
email: kkong@dir.ca.gov
phone: 510-286-6753
fax: 510-286-6862
Trading Partner Letters C, G, H, M, P-R

Antoinette Esqueda
email: aesqueda@dir.ca.gov
phone: 510-286-6773
fax: 510-286-6862
Medical Reports Technical Contact

Contents of this bulletin do not change existing regulatory requirements; they provide additional or revised detail about the technical implementation of those requirements. All technical changes will subsequently be reflected in other WCIS documentation. Any bulletin can be forwarded as needed, but should be forwarded in its entirety and without modification. If you have received a forwarded copy of this bulletin and are concerned about its authenticity, you can view this and previous bulletins on our WCIS web site: http://www.dir.ca.gov/dwc/wcis.htm.

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