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Georgia Implements Electronic Filing Regulations
Author: | Sunday September 27, 2009
New Rules Mark Transition to Electronic Filing System
GA State Board of Workers' Comp
Electronic Filing Rules Now in Effect
As of July 1, rules address procedures for
online filing and Electronic Data Interchange
By Jan Dillard
The 2009 Rules of the State Board of Workers’ Compensation became effective July 1, 2009. They contain organizational, editorial, and substantive changes. A majority of the Rule changes this year involve procedures for electronic filing associated with both online filing and EDI (Electronic Data Interchange). Changes to several Board forms were also effective July 1, 2009.
Several rules, including a new Rule 62, address EDI. The procedure for filing form attachments provides that they shall be mailed simultaneously or electronically filed and shall contain the employee’s name, date of injury, and Board claim number. Rule 131 now incorporates the claims office address on the EDI Trading Partner Agreement as an official address of record for service of notices.
Rule 221(4) adds a new subsection (b) which covers the procedures for suspending income benefits based upon a release to return to work without restrictions when filing via EDI.
Other changes include Rule 202 was amended to change the pre-payment amount of an IME to $600.00 as provided in the fee schedule. Rule 205 (b) (3) (a) was amended to require attachment of medical records to a WC-205. Rule 61 (b) (16) was amended to provide that WC-26 Consolidated Yearly Report of Medical Only Claims and Annual Payments on Indemnity Claims shall be filed on or before March 1st (previously January 31st), which coincides with SITF reports.
The 2009 Rules and 2009 Forms are available on the State Board’s website at www.sbwc.georgia.gov. Select “Statutes and Rules” or “Forms” located on the top left side of the web page.
Decrease in Loss Costs
NCCI (National Council on Compensation Insurance, Inc) has released the findings of a study of Georgia Workers’ compensation premiums and losses. NCCI analyzed the emerging experience of Georgia workers compensation policies in recent years.
The primary focus of the analysis was on premiums and losses from policy years 2005 and 2006, evaluated as of December 31, 2007. As a result of the findings, NCCI recommended a decrease for loss costs of -7.9% effective July 1, 2009.
This reduction is due to the continued downward trend in claim frequency and the fact that the indemnity loss ratios have been declining.
EDI Update
Effective July 1, 2009 the Board began operating under the mandate for Electronic Filing which includes EDI well as On-line submissions by attorneys.
The Georgia EDI implementation includes lost time claims with dates of injury July 1, 2009 or later. Extensive IAIABC Release 3 specifications for the Georgia implementation are available on the Boards web-site under EDI Updates. A short PowerPoint presentation that identifies Georgia EDI exception processes is also posted there.
After an extensive period of testing in the first quarter, April 2009, marked the production rollout of EDI (IAIABC Release 3), a new preferred standard for receiving workers’ compensation claims data in Georgia. As a result of the EDI implementation, FROIs and SROIs have now become a part of the daily vocabulary of claims processing in Georgia.
Currently there are over 340 trading partners (insurance carriers, self insured employers, group funds, third party administrators and vendors) in production transmitting workers’ compensation claim data in FROIs and SROIs nightly to SBWC.
In the second quarter 2009, ICMS statistics showed that 3 percent of the total claims filed were EDI. The Board is realizing steady progress toward its goal to have 85% of the claims volume reported in Georgia come through the EDI interface by year end.
Trading partners who have not yet communicated their plans for EDI to the Board should complete the Application for EDI. The application can be found on the website along with the GA EDI Implementation Tables. The completed application should have been filed in the EDI mailbox EDI@SBWC.GA.GOV" by August 31, 2009 but you can ask for an extension.
The Board recognizes that implementing EDI Release 3 may represent a complex and significant upgrade for our trading partners and have provided a Request for Extension for those who are still working toward this goal and need more time to complete testing and implementation.
Trading partners may request up to a 3 month extension and the deadline for the extension request is August 31, 2009. The application for the extension should be requested by sending an email to the EDI@SBWC.GA.GOV .
Updates on our Web Site
SBWC provides updated information on the Website to give our customers quick answers and a better understanding of ICMS. Specific items you can now find on the SBWC website include:
Supplemental Guide on Understanding ICMS and each Tab & Link
How to Create a New Claim
How to file a fee Contract
How to file a 102b/102c
How to file a form with attachments
How to file attachments that are non form driven
Questions and answers
Thanks to all of you who make Georgia’s workers’ compensation system one of the best!
Ed. Note: Jan Dillard, Ph.D., PMP - ICMS Project Manager, Glenridge Consulting Group.
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