eClaims Inquiry is a web application which provides the ability for Trading Partners (Senders), Vendors, Insurers and Third Party Administrators (TPAs) to view both accepted and rejected claim transactions submitted to the Board. eClaims Inquiry also allows Insurers, Self-Insured Employers, Municipalities and TPAs the ability to view their payor compliance reports, along with requesting review of any penalties associated with these reports.
Effective 9/20/2019, eClaims Inquiry has been expanded to include the ability for Flat File (FTP) Trading Partners (Senders) to view their FTP acceptance rate performance to determine if they are meeting the 90% acceptance rate target as stated in the eClaims Implementation Guide Part 3.9. The expansion includes the following reports:
This chart displays the target percentage of 90% and the actual FTP acceptance percentage per month. It also includes the number of transactions submitted, rejected and accepted in that month.
This report includes rejections that returned listing error type along with the error message received for each field that was rejected each month. It includes two FROI/SROI examples that can be viewed in the eClaims Inquiry FROI/SROI transaction search application to develop a corrective action plan to improve coding of edits.
To request access to eClaims Inquiry, Trading Partners and Vendor administrators should register using the eClaims Administrator web application.
Insurers and Third Party Administrators who are NOT Trading Partners should use the registration form found on the Register for eClaims Inquiry page. You will be required to designate an Administrator who will use the eClaims Administrator online web application to request or remove access for employees who will be using eClaims Inquiry to view submitted transactions.
Questions can be directed to: eClaimsTradingPartner@wcb.ny.gov