EDI Claims Reporting

Evolution of the EDI Claims Reporting Standards

In the 1970s, various state legislatures began questioning how their workers’ compensation systems were working compared to other state systems, and in the 1980s the International Association of Industrial Accident Boards and Commissions (IAIABC) created a Statistics Committee, whose task it was to identify, compare, and standardize injury data across jurisdictional boundaries. As technology boomed in the 1990s, insurance carriers and jurisdictions met in an effort to continue the standardization process in order to develop electronic reporting of injury data.

The result was the formulation of the IAIABC Electronic Data Interchange (EDI) Steering Committee, which created technical working groups. These groups focused on defining common data elements used when filing claims and developed a standard format for the electronic transfer of claims data from jurisdiction paper report of injury forms. Participants met under the auspices of the International Association of Industrial Accidents Boards and Commission (IAIABC) to satisfy antitrust requirements.

The discussions of this group resulted in the creation of a data element dictionary and a reporting event table that could be used by any state and which was based on the claims administrator claim handling process with consideration for the jurisdictional-required employer reports filing. This utilized existing and widely used data standards to leverage system enhancements implemented by many claims administrators and state administrators.

This process took several years to fine tune into the national standards existing today. The standards continue to be reviewed and enhanced by a committee of jurisdictional and insurance industry participants for the benefit of all.

Iowa DWC EDI Claims Release

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