EDI POC Frequently Asked Questions

 

1. I have a TE on my acknowledgement report, what do I do?

You must fix the error and then correct the TE by filing a FROI CO using the jurisdiction claim number provided in your acknowledgement report.

2. I have a TR on my acknowledgement report. What does it mean and how do I fix it?

A TR on your acknowledgement report means that the transaction was completely rejected. You must fix the errors that caused the rejection and resend the transaction as if you had never sent it in before.

3. I need to file a denial but I am unsure if you have a first report in your system. What should I do?

Call your contact at the WCB to obtain a WCBN if available. If it is not on our system you will need to file the FROI EDI as well as the denial.

4. Can I file a first report of injury and a denial (SROI04) at the same time?

If it is a NEW first report and a full denial you may file these at the same time by sending in a FROI 04. If the WCB has already received the FROI you will need to obtain the WCB file number and use that to file your denial. If you are filing a Partial Denial, you must file the first report and wait for acknowledgement and the WCBN and then file your SROI PD.

5. How do I know which MTC to use when correcting TE’s or reconciliation report?

When you receive a TE on your acknowledgement report, you must use the MTC “CO” to make the corrections. If you are correcting things from the reconciliation report when you have previously received a TA on your acknowledgement report, you must use the MTC “02” in order to make changes. Any other MTC will result in a TE.

6 I received a letter from the WCB stating that a claim has been started as a result of receipt at the WCB of a subsequent report (i.e. petition or memorandum of payment). What do I do?

The letter contains a WCB file number. Use this number to file a 148-UR.

7. I sent a Denial in the past and something new has happened in the claim. How do I know if I should send another one?

You have to send in a Denial for each period of incapacity if you are disputing indemnity or additional medical bills or issues.

8. I only have an error number on my acknowledgement report, how do I find out what the error is?

Go to your directory in your outbound box. Double click on Reports and scroll down until you find a file named list_of_errors.d The first column gives you an error number. The second column gives you the DN that the error is related to. The third column is an error identifier that IAIABC uses. The next column is the IAIABC description of the error and the last column is the WCB description of the error.

9. Can I file a SROI 04 denial on a Medical Only claim? What if it becomes a lost time claim after I file the SROI 04 on the Medical Only, do I need to send another SROI 04?

Yes you can file a full denial on a MO FROI. You will not have to fill in any incapacity dates on the denial. If the claim becomes Lost Time, you will have to do a FROI 02 to change the Claim Type Code (DN74) from “M” to “L” (became Lost Time). Then you will have to file another SROI 04 pursuant to Rule 1.1 for the incapacity period.

10. How do I report loss of earnings but no lost time?

Send in a Medical Only FROI to the board via EDI and send in a Memo of Payment to the Board via paper.

11. Can I fax First Reports of Injury or Notices of Controversy to the Board?

All First Reports of Injury and original Notices of Controversy must be sent via EDI. If you are amending a Notice of Controversy that has been sent and acknowledged via EDI, you can only amend it by mailing or faxing it to the WCB. Be sure to clearly indicate that it is amended and clearly identify what information is being amended. If the Claims Manager cannot determine one or both of these factors, the NOC will be returned to you with a letter stating that it was not entered in the WCB system.