Workers' compensation information system (WCIS)

Medical Bill Reporting

The Workers’ Compensation System (WCIS) was mandated by statute in 1993. Its primary objective is to provide State policy makers with reliable, independent information regarding the performance of the California’s workers’ compensation system. California Labor Code §138.6 mandates the data to be collected via electronic data interchange (EDI) according to the EDI standards developed by the International Association of Industrial Accident Boards and Commissions (IAIABC).

The WCIS has been electronically collecting medical bill data since September 2006.  Data collected has information regarding medical diagnoses, treatments, providers and payments. The WCIS currently uses (IAIABC) Medical Release 1.1 standard for data collection.  The Release 1.1 standards are based on the ASC X12 4010 standard. Medical bill data is sent to WCIS in ASC X12 837 files via electronic data interchange (EDI). The data fields collected by WCIS can be seen in California EDI Implementation Guide for Medical Bill Payment Records Version 1.1.

August 2015