Medical bill reporting variance request update

As stated in today's California EDI medical task force teleconference, any claims administrator who is unable to submit the data elements 516 (total amount paid per bill) and 574 (total amount paid per line) pertaining to zero payments and unbundled lien payments should file for a six month partial variance pursuant to regulation section 9702 (a)(1). The variance request must be submitted by Sep. 22, 2006. Please set forth as much information as possible at this time and indicate that the plan will be amended within the next six months. The division will continue to work with the trading partners to develop a plan to help the claims administrators comply with the reporting requirements. Please also note that section 9702(a)(3) provides “A claims administrator granted a variance shall submit to the WCIS all data elements that were required to be submitted under subdivision (e) during the variance period except for data elements that were not known to the claims administrator, the claims administrator’s agents, or not captured on the claims administrator’s electronic system.”

A variance request checklist can be downloaded at http://www.dir.ca.gov/DWC/WCISenews/MedicalBillReportingVarianceRequestChecklist.pdf. Please email David Henderson at dhenderson@dir.ca.gov or Bill Kahley at bkahley@dir.ca.gov with any questions regarding the variance request.

Damon Chen
email: dcchen@dir.ca.gov
phone: 510-286-6753
fax: 510-286-6862
Trading partner letters C, G, H, M, P-R

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

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

---

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.

Format: This WCIS e.News is sent in HTML format, and is best viewed in that format. Consult your e-mail application's help files or your computer support unit for assistance in viewing HTML-formatted e-mail.

Distribution: To subscribe send an e-mail to wcis@dir.ca.gov with the word "subscribe" as the subject of the message. Include your name and organization in the body of the message. To unsubscribe send an e-mail to wcis@dir.ca.gov with the word "unsubscribe" as the subject of the message. To change your e-mail address, first unsubscribe then subscribe with your new address.

---