WCIS eNews No. 90
June 1, 2012

New FROI/SROI and Medical Guide Implementation Date

The cutover date for version 3.0 of the California FROI/SROI implementation guide and version 1.1 of the California medical implementation guide is scheduled for Monday, June 18, 2012 at 12:01 am PDT. The transition will occur over a seven day period, from Monday, June 18 to Monday, June 25. During this time, we will continue accepting FROI/SROI and medical data transmissions, although transmission of acknowledgements will be delayed for approximately one week. Files received before June 18 will be processed under the current guidelines while files received on or after June 18 will be processed under the new guidelines.

A copy of the new guides can be found at: http://www.dir.ca.gov/dwc/DWCPropRegs/WCIS_Regs/WCIS_Regulations.htm. Major guide changes are listed in Appendix A.

WCIS FTP transmission requirement

Beginning June 18, 2012, the only transmission options for both FROI/SROI and medical data reports will be via a secure FTP site hosted by the WCIS. Files must be transmitted using FTPS (FTP over SSL, RFC4217). In addition, trading partners may optionally use PGP (Pretty Good Privacy, RFC4880) to encrypt the files before transmission. The WCIS FTP host is ready for beta testing with all  that are currently sending data via other methods. Trading partners must switch to the new transmission method before June 18, 2012. Please contact your WCIS trading partner contact to begin the transition. Trading partners that send data through an EDI vendor should verify that their vendor will be ready to transmit to the WCIS FTP host by June 18. Beginning June 18, we will no longer accept data sent via any other transmission methods, such as email and VANs.

Please also note that the WCIS receiver zip code will also be changing to 94612-1489 on June 18, 2012. If you would like to switch to the new receiver zip code sooner, please contact your trading partner contact.

Revised California EDI Trading Partner Insurer/Claim Administrator ID List

Beginning June 18, 2012, the nine-digit Claim Administrator Postal Code (DN14) must be listed for each entity reported on the California EDI Trading Partner Insurer/Claim Administrator ID List. A list of all claim administrator/insurer FEINs and claim adjusting locations must be reported for each Sender ID. The WCIS database uses these data to process individual transactions and may reject transactions for unknown claim administrators and adjusting locations.

Please email an updated insurer-claim administrator ID list to your assigned WCIS trading partner contact byJune 14, 2012. The instructions and form are attached for your convenience. Please notify your trading partner contact whenever any information changes in the ID list.

Electronic medical billing/payment provider information

In order to facilitate implementation of electronic medical billing, DWC will post a list of electronic medical billing/payment providers on the web. DWC invites interested vendors of electronic medical billing/payment services or software to submit contact information to DIRe-billing@dir.ca.gov for posting. Please provide the company name, contact name, address, phone number, fax number, email address and website address. DWC will not be “approving” or “endorsing” any of the service providers, but will post the information for the convenience of the public.

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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