Acceptance Of Claims

Acceptance Of Claims For SROI (Subsequent Report of Injury) Reports

Acceptance Of Claims EDI transactions for SROI (Subsequent Report of Injury) reports are suspended by the North Carolina Industrial Commission. The Commission will continue to accept and process Claims EDI transactions for FROI (First Report of Injury) reports with the exception of the FROI 04 Denial.  In order to maintain the integrity and efficiency of the administration and adjudication of workers’ compensation claims, the Commission will be pursuing an IRR (Issue Resolution Request) with the IAIABC (International Association of Industrial Accident Boards and Commissions).  The goal of the IRR would be to allow carriers and employers to report specific body parts for which liability and compensability are accepted and/or denied. The Commission will provide updates on the progress of the IRR and future plans for SROI reports as they become available.

The following Claims EDI transactions will continue to be accepted by the Commission:
  • FROI 00 (Original)
  • FROI 01 (Cancel)
  • FROI 02 (Change)
  • FROI AQ (Acquired Claim)
  • FROI AU (Acquired / Unallocated)
  • FROI CO (Correction)
Trading Partners submitting FROI EDI transactions should not submit a Form 19 to the Commission. Until further notice, and based on the NCIC Event Table, the following Claims EDI transactions (FROI/SROI reports) will not be accepted and Trading Partners will receive a rejection acknowledgement (TR) from the Commission:
  • FROI 04 (Denial)
  • SROI 02 (Change)
  • SROI 04 (Denial)
  • SROI AP (Acquired / Payment)
  • SROI CA (Change in Benefit Amount)
  • SROI CB (Change in Benefit Type)
  • SROI CO (Correction)
  • SROI EP (Employer Paid)
  • SROI ER (Employer Reinstatement)
  • SROI FN (Final)
  • SROI IP (Initial Payment)
  • SROI PY (Payment Report)
  • SROI RB (Reinstatement of Benefits)
  • SROI RE (Reduced Earnings)
  • SROI S1 (Suspension, Return to Work, or Medically Determined/Qualified Return to Work)
  • SROI S4 (Suspension, Claimant Death)
  • SROI S7 (Suspension, Benefits Exhausted)
  • SROI S8 (Suspension, Jurisdiction Change)
  • SROI SD (Suspension, Directed by Jurisdiction)
All carriers and employers shall submit the appropriate IC Forms (Forms 60, 61, 62, 63, 28, 28B, 28C, 28T) on paper or electronically. The Commission will be contacting Trading Partners who have submitted SROI EDI transactions to resolve any issues with those reports.
To learn more about HIPAA EDI Claims and become a certified  EDI Professional please visit our course schedule page.

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