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You are here: Home . wc . news . advisories . ad2000-04

Advisory 2000-04*

Electronic Reporting Compliance

In 1995, the Texas Workers' Compensation Act was changed to require electronic transmission of information to the Commission via Electronic Data Interchange or EDI. Over the last several years, the Commission issued a number of advisories dealing with EDI. Specifically, Advisories 95-05, 95-06, 97-03 and 98-02 notified carriers of the requirement to send information on claims and actions taken in claims to the Commission via EDI and laid out performance expectations and possible audit and enforcement actions.

In the last legislative session the statute was again changed to instruct the Commission to reduce paper filing requirements by increasing the use of electronic transmission. Further, in August of 1999, the Commission replaced most of its existing rules regarding carrier notification to the Commission with Rule 124.2 (relating to Carrier Reporting and Notification Requirements). This rule requires carriers to notify the Commission and claimant of actions taken on, or events occurring in a claim. The rule identifies the information that carriers are expected to provide to the Commission by EDI and the time frames for carriers to do so. Rule 124.2 became effective August 29, 1999.

In the past year, the Commission has been conducting audits and taking enforcement action consistent with Advisory 98-02. With the change in the rule and the length of time that carriers have had to come into compliance with the requirements of the statute regarding EDI (as well as the fact that there are a number of approved vendors/trading partners that can be used for EDI transmissions), the Commission is issuing this advisory to notify carriers of the Commission's intentions with regard to EDI and to withdraw Advisory 98-02. Instead, the Commission is monitoring all carriers for compliance with EDI requirements and will primarily schedule audits based on system data that identifies carrier performance and system impact. The scope of these audits may include, but is not limited to electronic (EDI) versus paper reporting, timeliness of filing, and quality of data reported.

Only carriers who have valid waivers to EDI reporting (in accordance with Commission Rule 124.2(k)) or an extension to the existing EDI schedule in effect will be excluded from compliance monitoring for the approved period .

In August, 2000 the Commission will provide each carrier/carrier group their compliance rates for electronic versus paper filing for the month of July, 2000. The notices will be distributed through the respective TWCC Representatives. The Commission will then commence EDI audits starting with the period of October, 2000.

Carriers that need to review the Texas EDI Implementation Guide for current reporting requirements can visit our web site www.tdi.texas.gov. To become a trading partner or arrange EDI Maintenance Type Code/Sequence testing, please contact EDI Development and Implementation at 512-804-4337.

Signed this 3rd day of August, 2000

Leonard W. Riley, Executive Director

Distribution:

TWCC Staff
Public Information List
Commission Representatives



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