EDI is defined as a computer-to-computer exchange of data in a standardized format. Each trading partner (insurance carriers, adjusters, third-party administrators who submit documents) must agree to use the standardized format and set of rules in order to participate in EDI. EDI is widely used in industry to transmit traditional documents such as invoices and purchase orders between companies. Standardized transactions sets have been developed so that hundreds of different documents now can be electronically exchanged. The result is a highly efficient means of conducting business. In fact, 38 states have already implemented EDI for their workers’ compensation data processing needs.
In addition to the many duties assigned to the division’s claims section, they are also required to code, enter, and microfilm all documents related to workplace injuries filed with the division by employers, carriers, and physicians. Last year there were 59,617 injuries in the state of Utah representing over 198,809 documents to process. This represents approximately 3,800 documents per week. EDI will streamline the submission of required documents by eliminating the need for most paper forms.
The International Association of Industrial Accident Boards and Commissions (IAIABC) is a private association of workers’ compensation professionals from public and private sectors with a basic objective to strengthen and improve the administration of workers’ compensation laws. On a national level, the IAIABC has spearheaded a program to use EDI for workers’ compensation. State jurisdictions, insurance carriers, self-insured employers, third-party administrators, vendors (those who process the electronic forms) and the IAIABC have formed national EDI committees to develop, implement and maintain EDI formats for the workers’ compensation system.