August 13, 2020
On March 31, 2020, the New York State Workers’ Compensation Board (Board) announced the upgrade from the International Association of Industrial Accident Boards and Commissions' (IAIABC) Claims Electronic Data Interchange (EDI) Release 3.0 (R3.0) to the IAIABC's Claims EDI Release 3.1 (R3.1). The IAIABC's Claims EDI is a national standard for trading partners to electronically submit employer claims data. The R3.1 release introduces new data reporting elements, which will improve accident and indemnity reporting related to injured worker claims. The Board’s commitment to efficient, electronic claims filing supports our ongoing efforts to improve services to workers injured in New York State, and to their employers. Currently, six states have adopted Claims EDI R3.1, and another seven states are scheduled for adoption through 2022.
In keeping with the IAIABC guidelines, the eClaims EDI R3.1 Requirement Tables and Implementation Guide were published on the Board’s eClaims website on March 31, 2020. The Board has worked closely with industry representatives and the IAIABC Implementation Committee to develop and finalize the precise reporting requirements, addressing stakeholder concerns whenever possible.
R3.1 Implementation Schedule
The implementation date for mandatory R3.1 reporting is targeted for March 15, 2021. There will be no staggered rollout. All trading partners must be ready to submit R3.1 reporting effective March 15, 2021, with no exceptions. Trading partners who use the flat-file submission method, are strongly encouraged to begin the necessary preparations now.
Mandatory R3.1 Testing
In advance of the March 15, 2021 implementation, all flat-file trading partners will be required to complete a flat-file testing and validation process as described in section 3.7 of the Implementation Guide. The flat-file testing begins on November 16, 2020 and runs through the end of February 2021. Trading partners using the Board’s eClaims Web Data Entry application can voluntarily participate in web submission testing, also available from November 16, 2020, through the end of February 2021.
R3.1 Resources & Training
The Board is conducting monthly eClaims webinars on the third Tuesday of each month to provide R3.1 guidance to all trading partners. Webinar announcements are sent to our registered eClaims trading partner contacts. The webinar information is also posted monthly, in advance of each date, on the Board’s Upcoming Webinar page. The Board has also established an eClaims R3.1 section on our website with up-to-date information and resources related to the R3.1 implementation, including a dedicated email address for questions (email@example.com).
In May of this year, the Board held an online training, and continues to present R3.1 informational material at the monthly webinars. All eClaims webinar presentations are recorded and posted on the Board’s website. Training on the national R3.1 standard is available on the IAIABC website.
Claim administrators are strongly encouraged to begin preparations immediately for the R3.1 implementation. The Requirement Tables and Implementation Guide should be reviewed and shared with both business and technical representatives within your organization. We urge claim administrators to pay close attention to those data elements defined as “mandatory” or “mandatory conditional”. It is recommended that insurers, along with their licensed third-party administrators, evaluate both business and technical processes to ensure their ability to collect and transmit information required by the Board in a timely and accurate manner, prior to the mandated implementation date.
Questions related to this announcement can be directed to firstname.lastname@example.org.
Clarissa M. Rodriguez