If a third party administrator uses its own claim numbering system that does not coincide with the insurer’s claim numbers that are reported in unit statistical records, what claim number must be reported for WCIRB indemnity transaction data submissions?
If a third party administrator uses its own claim numbering system that does not coincide with the insurer’s claim numbers that are reported in unit statistical records, what claim number must be reported for WCIRB indemnity transaction data submissions?
Question:
If a third party administrator uses its own claim numbering system that does not coincide with the insurer’s claim numbers that are reported in unit statistical records, what claim number must be reported for WCIRB indemnity transaction data submissions?
Answer:
The Claim Administrator Claim Number (DN 0015) and Policy Number (DN 0028) reported for the Indemnity Data Call must match the claim number and policy number used for unit statistical reporting. The ability to match these values allows the WCIRB to use the statistical claim information and medical transaction data along with the indemnity transaction data in actuarial analysis.