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Integrated Claims Management System (ICMS) Update
Author: | Monday September 01, 2008
Some of the team members working to develop the Integrated Claims Management System (ICMS) celebrated the progress made to date. They also know there is a lot more to do.
ICMS and a Keen Eye
By Jan Dillard, Ph.D, PMP, ICMS Project Manager
The wonders of automation often require us to have a very keen eye. Such is the case with ICMS (Integrated Claims Management System) of the State Board of Workers’ Compensation. Some of you have recently discovered challenges when your eye is not so keen!
Possible Challenges with ICMS
You may have recently discovered that your claims are not in the electronic system or that you had a paper form returned from the Board. Administrative Rule 61 mandates that all documents filed with the State Board of Workers’ Compensation are to be complete and legible. The Board finds the following errors most commonly lead to returned forms or the inability to process the claim in ICMS.
Include all Information
Be sure to complete all information requested on a Board form. Particularly important is the insurer/self insurer SBWC ID number. This is the unique number assigned to Insurers and Self Insurers. If you do not know an organization’s SBWC ID number, go to the Board’s web site at www.sbwc.georgia.gov.
Remember sections B,C, or D for a WC-1
Board Rule 61 requires that section “B”, “C”, or “D” must be properly completed when submitting Form WC-1 (Employer’s First Report of Injury or Occupational Disease).
Remember that only a Form WC-1 or Form WC-14 creates a Board file.
Make all documents legible.
Illegible copies are difficult to scan into the system. Please be sure ALL correspondence is legible and that Information is typed or printed in black ink.
Use current Board forms
Be sure to use the most current Board forms. Current Board forms can be downloaded from the Board’s website at www.sbwc.georgia.gov.
Do not alter Board forms
Include only the information requested on the form and put it in the space provided. Do not create additional space, do not change the names of text fields, do not extend parts of the front page to another page, do not extend the information to the back of the form and do not send the instruction side as a separate page.
File only one form for each date of injury
A separate form must be filed for each date-of-injury. Multiple dates-of-injury are not accepted on one form because ICMS creates a new claim number for each date of accident.
Important Claims Office data
ICMS establishes a link between the insurer/self-insurer/group self-insurer and their designated claims offices. The SBWC ID number assists, and in most cases, ensures the correct relationship between insurance entity and claims office. Please use this SBWC ID number. Refer to the list of SBWC numbers on our web page at www.sbwc.georgia.gov.
It is the responsibility of the Insurer to notify the Board of all claims offices handling their claims. The insurer must file a Form WC-121 for each claims office. If you suspect that ICMS does not have your current claims offices identified, please file a WC-121 to add, delete or replace a claims office.
The Board encourages the responsible claims office to create a single electronic mail box to receive all automated email notifications.
Online Filing
If you are a registered ICMS user, you may now file your forms over the Internet. Filing forms over the Internet for existing claims is straightforward, secure and user friendly. Filings are made from within the individual claim files. ICMS already “knows” the parties to the claim and the date of accident for each claim file. ICMS automatically captures submitter information from your login and the filing date. Check-boxes indicate the purpose of a particular filing.
The information you supply relates to the specific purpose of the filing, e.g. a motion or request for hearing. Attaching supplemental materials or briefs are possible through links on the web “form”. Briefs, motions, objections and supplemental documents have page limits and must be approved in advance by an Administrative Law Judge or the Board. Refer to our web site and current Board Rules effective July 2007 for page restrictions and accepted formats www.sbwc.georgia.gov ).
To become a registered user, you must first attend a training session. Check the Board’s website www.sbwc.georgia.gov for upcoming training sessions. The Board will be hosting an Electronic Filing Mandate Preview at the Annual Seminar in August. Information about this Preview will be available at the registration desk.
Update on EDI Implementation
The Board continues the testing and piloting of the first EDI (Electronic Data Interchange) data submissions. EDI allows insurers and self-insurers to submit large volumes of data electronically into ICMS as an alternative to sending paper forms for NEW workers’ compensation claims.
The Georgia EDI Implementation Tables are available from the SBWC website under EDI Updates. These tables identify the Georgia implementation of the IAIABC Release 3 Data Elements for claims and are useful for designing a response to the transmission requirements.
Once the Board successfully completes these Pilots, we will begin to release EDI functions to licensed insurers and self-insurers. EDI will be deployed in three groups. Insurers, Self-Insurers, Group Funds and their respective claims offices have been asked to sign up for one of the three EDI Groups. If you have submitted an application for a group, you do not need to resubmit. If you have not signed up for an EDI Implementation Group, the Board will assign you to a group soon.
Electronic filing, whether via online web-filing or EDI, will become mandatory for all insurers and self-insurers by 2nd quarter 2009. The Board will be hosting an Electronic Filing Mandate Preview at the Annual Seminar in August. Information about the Preview will be available at the registration desk.
We are excited about our progress. We know that you will find these new functions to be helpful and easy to use.
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