OSCAR and EDI
KS EDI 3.1: On November 29, 2018, Kansas implemented EDI Release 3.1. The Kansas EDI 3.1 release date coincides with go-live of Kansas’ Online System for Claims Administration Research/Regulation (OSCAR). Kansas EDI data will be integrated into OSCAR and some of the new requirements in claims 3.1 are needed to support OSCAR functionality and processes.
Requirements Tables
Trading Partner Documents
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KS EDI 3.1 Trading Partner Documents
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KS EDI 3.1 Imp Guide - 'KS 3.1 Requirement Tables Added'
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KS EDI 3.1 Test Requirements
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KS EDI IAIABC Electronic Partnering Agreement
KS EDI 3.0 Migration to 3.1 (Open and Re-opened Claims)
- Kansas R3.1 FROI UR Trigger - Any open or reopened claim previously reported via IAIABC R3.0 prior to 11/29/2018. Must be sent prior to submitting any other First Reports of Injury for claims that were initiated before implementation of R3.1
- Kansas R3.1 SROI UR Trigger - Any open or reopened claim previously reported via IAIABC R3.0 prior to 11/29/2018. Must be sent prior to submitting any other Subsequent Reports of Injury for claims that were initiated before implementation of R3.1
- Kansas R3.0 Migration Claim Submissions - Kansas expects the FROI UR and SROI UR submissions for R3.0 migration claims to be completed by January 11, 2019
Statutes
44-557a. Compilation and publication of statistics; database of information; submission of data; contracts for actuarial or statistical services. (a) The director shall: (1) Compile and publish statistics to determine the causation of compensable disabilities in the state of Kansas and (2) compile and maintain a database of information on claim characteristics and costs related to closed claims, in order to determine the effectiveness of the workers compensation act to provide adequate indemnity, medical and vocational rehabilitation compensation to injured workers and to return injured workers to remunerative employment. The commissioner of insurance shall cooperate with the director and shall make available any information which will assist the director in compiling such information and statistics and may contract with the director and the secretary of the department of health and environment to collect such information as the director deems necessary. The secretary of revenue shall cooperate with the director and shall disclose individual income taxpayers names, addresses and social security numbers to the director to be used solely for the verification of workers compensation data files. For purposes of this subsection, such disclosure shall not be considered the disclosure of any particulars of a report or return
(b) In order to further the purpose of subsection (a), each self-insured employer, group-funded workers compensation pool and insurance carrier shall submit to the director the disposition of a statistically significant sample of closed claims under the act. Unless provided by regulations to the contrary, on or after January 1, 2004, any insurer, group-funded workers compensation pool or self-insured employer who voluntarily submits claim information to the director pursuant to release 1 of the international association of industrial accident boards and commission’s electronic data interchange implementation guide dated August 9, 1995, and amendments thereto, up to April 4, 2002,
(c) Each self-insured employer, group-funded workers compensation pool, insurance carrier or health care facility shall submit medical information, by procedure, charge and zip code of the provider, or by hospital charge and related diagnostic and procedure codes in order to set the maximum medical fee schedule
(d) The director may contract for professional actuarial or statistical services to provide assistance in determining the types of information and the methods of selecting and analyzing information as may be necessary for the director to conduct studies of closed claims under the workers compensation act and to enable the director to make valid statistical conclusions as to the distribution of costs of workers compensation benefits
(e) The director shall obtain such office and computer equipment and employ such additional clerical help as the director deems necessary to gather such information and prepare such statistics
(f) If a self-insured employer, group-funded workers compensation pool or insurance carrier fails to supply the information required by this section, the director shall issue and serve upon such person a summary order or statement of the charges with respect thereto and a hearing shall be conducted thereon in accordance with the provisions of the Kansas administrative procedure act. An administrative penalty of up to $500 for each violation or act, along with an additional penalty of up to $100 for each week thereafter that such report or other information is not provided to the director shall be imposed
History: L. 1974, ch. 203, § 44; L. 1993, ch. 286, § 60; L. 1997, ch. 125, § 14; L. 2000, ch. 160, § 17; L. 2002, ch. 122, § 5; July 1; L. 2003
Administrative Regulations
This report primarily serves as a method for trading partners to monitor the quality of their reporting to the Division, providing the opportunity to address potential issues and to improve data quality. A secondary reason is to ensure compliance with the Division’s quality standard.
Beginning July 1, 2004, the Division formally implemented its data quality standard for the EDI program. The quality standard is as follows: a minimum of 85% of all FROI/SROI reports per quarter are accepted with a TA or TE status and no more than 15% of all reports are rejected with a TR status.
EDI Quality Report
The Reports linked below will take you to an Excel spreadsheet file containing two worksheets: ‘Quality’ and ‘Uncorrected Errors.’
The ‘Quality’ sheet contains the quality data for each trading partner. The columns of this sheet are organized as follows: trading partner name, TA count, TE count, number of uncorrected TE reports, TR count, TA percentage, TE percentage and TR percentage. The percentages are based on total reports sent per trading partner for the quarter. Compare these percentages to the quality standard stated above to determine if any action on behalf of the trading partner is required (see action items below).
If you have any uncorrected TE counts, please see the 'Uncorrected Errors' sheet to see which claims contain the TE. Please make corrections using a CO report as soon as possible. All TE reports should be corrected (see action items below).
Action Items: Use the quality data to compare to the standard to determine what following action is required on behalf of the trading partner.
- If your quality report meets or exceeds the Division’s quality standard, then nothing is required
- If your quality report is below the Division’s quality standard, please submit a response to the Division within five business days of receipt of the notification email that the quality report is available. This response should contain a brief and general description of the circumstances that led to the errors listed in this report (e.g., new employee, new software, hardware issues, etc.) and any action taken to resolve those issues
- If you have any outstanding TE reports that need correction, please do so immediately
Previous EDI Quality Reports
https://public.tableau.com/views/KansasWorkersCompensationEDIQuarterlyReportQ42022/TRStatsDashboard?:language=en-US&:display_count=n&:origin=viz_share_link will take you to a series of tables and graphs that can be interactively changed by the user, based on a particular year and quarter within that year. This will allow Trading Partners to see their yearly trends regarding EDI Reporting compliance. You can also find each table/graph, as well as counts of TAs, TRs, and TEs by quarter, listed individually at the bottom of the page.
2022 Reports
2021 Reports
2020 Reports
2019 Reports
2018 Reports
For business/law/regulations issues and questions, please contact:
For the Kansas EDI Coordinator and KWC Vendor Help Lines at Ebix, please contact (866) 448-1776 or (614) 877-2501 (FAX), or KS-EDICoordinator@Ebixrisk.com.
For the International Association of Industrial Accident Boards and Commissions (IAIABC), please contact (608) 633-6355 or visit the IAIACB website.
For the U.S. Department of Commerce U.S. Census Bureau North American Industry Classification System (NAICS), please visit the NAICS website. Please note that Kansas accepts the 2017 codes only.
The following is a list of EDI vendors currently submitting workers compensation claim reports in other jurisdictions and have proven technical and business capability to comply with the Kansas EDI Implementation Guide. This list is for informational purposes only and KDWC does not endorse and/or recommend the services of any one vendor.
Refer to the IAIABC and other EDI standard setting organizations for additional EDI vendors.