1 / 49

POP QUIZ: What MTC is used to retract an EDI DWC-1 filed in error with DWC

jalen
Download Presentation

POP QUIZ: What MTC is used to retract an EDI DWC-1 filed in error with DWC

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. 1

    2. 2

    3. 3

    4. 4 FROI MTC 01 is required to be filed with DWC to report the cancellation of the claim in its entirety. It is not used to cancel an individual MTC sent in error. FROI 01 - Cancel Rules

    5. 5

    6. 6

    7. 7

    8. 8 … you will probably want to keep the one filed with DWC the earliest & file MTC 02 to correct SSN/DOI as applicable; then file the FROI 01 to cancel the other one.

    9. 9 FROI 01 should also be sent if the claim was transferred to another jurisdiction and no indemnity benefits were ever paid/reported to DWC because… FROI 01 - Cancel Rules

    10. 10 … Claim was initially denied (FROI 04, 00/PD), or Claim was reported as compensable death, no dependents or volunteer (00/CD, 00/VE). FROI 01 - Cancel Rules

    11. 11 Under these circumstances, SROI S8 (Jurisdiction Change) is not applicable because there are no indemnity benefits being suspended. FROI 01 - Cancel Rules

    12. 12 Per IAIABC standard Cancel Rules, when FROI 01 is filed, DWC will flag the associated claim in its database as “cancelled”. This means the claim is no longer considered to be “on file” with DWC. FROI 01 - Cancel Rules

    13. 13

    14. 14

    15. 15

    16. 16

    17. 17

    18. 18 To “un-cancel” a previously accepted FROI 01, the Claim Admin. must file a new Electronic First Report or Injury or Illness via: FROI MTC 00 (or AU) + SROI, or FROI 04, depending on the situation.

    19. 19 Caveats and Tips for Filing FROI 01 After cancellation/re-establishment, the Claim Admin. will NOT receive credit for the original filing date for the claim that was cancelled. The new FROI/SROI filing will be evaluated for timeliness by DWC.

    20. 20 Caveats and Tips for Filing FROI 01 If the FROI 01 was filed in error and the entire claim was never intended to be cancelled, contact the Claims EDI Team for assistance.

    21. 21

    22. 22

    23. 23

    24. 24

    25. 25 If a claim is being transferred TO FL …. Cancel/Transfer Rules

    26. 26 The FROI/SROI or FROI 04 sent to establish the claim with FL should include Late Reason Code "L4" (Late Notification, Jurisdiction Transfer). Cancel/Transfer Rules

    27. 27 Cancel/Transfer Rules

    28. 28

    29. MTC “S8” is used to report the suspension of all indemnity benefits when a claim is transferred to another jurisdiction after indemnity benefits have been initiated, i.e.,

    31. 31 No further EDI filings (e.g., SROI MTC FN) are required to be sent to the Division after the acceptance of MTC “S8”.

    32. 32 Reminder: Jurisdiction Transfer Claim administrator then sends the following to the appropriate state (if applicable): FROI MTC “00” SROI MTC “IP” (or other applicable SROI)

    33. 33

    34. 34

    35. 35

    36. 36

    37. 37

    38. 38

    39. 39

    40. 40

    41. 41

    42. 42

    43. 43

    44. 44

    45. 45

    46. 46

    47. 47

    48. 48

    49. 49

    50. 50

More Related