WC FROI & Policy
According to CBCS Best Practices, a workers’ compensation claim should be set up within this amount of time after it is received.
What is three hours?
This team ensures workers’ compensation claims are electronically reported to the appropriate jurisdictions within required timelines.
What is the EDI Team?
This maintained balance is held in a claim account, used to pay claims, and replenished periodically.
What is an escrow balance?
Best practices recommend waiting this many days after an accident before beginning a police report search.
What is seven days?
This annual meeting reviews program performance, trends, successes, and recommendations with the client and broker.
What is a stewardship review?
A digital workers’ compensation claim typically takes this long to set up.
What is three to five minutes?
This initial filing notifies a state that a work-related injury has occurred.
What is a FROI, or First Report of Injury?
This request is submitted to determine whether a check has cleared the bank.
What is a check tracer request?
After receiving a police report, the coordinator completes this important step in Claims Enterprise.
What is updating the claim file?
This document is reviewed during implementation and revisited annually to keep claim-handling expectations and program requirements current.
What are Special Handling Instructions?
This is the state used to determine the appropriate NCCI code.
What is the hired state?
Understanding and interpreting these jurisdiction-specific requirements is a unique responsibility of the EDI Team.
What are State Tables?
This fraud-prevention service compares payments issued by CBCS with items presented for payment at the bank.
What is Positive Pay?
Police Report Coordinators typically schedule follow-up diaries this far into the future for outstanding requests.
What is four weeks?
This account-management activity identifies trends, discusses significant exposures, and tracks follow-up items with the client.
What is a claim review?
A workers’ compensation coordinator is expected to issue this many payments each week.
What is 200?
When claim information is incorrect and the state effectively says, “Try again,” this occurs.
What is an EDI rejection?
This internal control prevents one person from controlling payment issuance, approval, and reconciliation.
What is segregation of duties?
When a report is unavailable online, occurred on private property, or the responding agency is unknown, the coordinator takes this action.
What is calling the police department?
This CBCS department often partners with Account Management to resolve system access issues, RMIS concerns, and service ticket requests.
What is IT?
According to CBCS best practices, this is the maximum amount of time allowed after a claim is established before a coverage note must be entered.
What is 3 hours?
This filing reports claim activity occurring after the initial injury report, including payments, suspensions, and closures.
What is a SROI, or Subsequent Report of Injury?
A client maintains a $50,000 escrow balance. If $8,000 in claims is paid during the month, the client must replenish this amount at month-end.
What is $8,000?
This type of request is used to obtain non-police-report documents or materials from law enforcement or government agencies.
What is a FOIA, or Freedom of Information Act, request?
This Medicare-related reporting requirement helps ensure compliance with the Medicare Secondary Payer Act and federal reporting obligations.
What is Medicare RRE reporting?