Explanation of the batch claim submissions process

The batch claim process lets workers’ compensation insurers file first reports of injury electronically with the Department of Industrial Accidents (DIA). The DIA sends notification back letting insurers know if their filings were accepted or rejected.

The Batch Claims Submission (BCS) process at the Department of Industrial Accidents (DIA) helps to process first report of injury (FROI) claims from authorized insurance providers using Electronic Data Interchange (EDI) protocols.

Process

Once a provider is authorized by the DIA and a sender identification has been registered in our system, a Secure File Transfer Protocol (SFTP) account will be set up where first reports of injury (FROI) transactions can be sent and acknowledgements can be received. The FTP account will have both:

  • An inbound folder where FROI transactions are dropped off
  • An outbound folder where acknowledgements of previously sent transactions are picked up

Transactions sent to the DIA are automatically processed several times a day. Transactions that are validated by the Electronic Data Interchange (EDI) process still need to be approved by the DIA's Claims Processing Department before a board number can be assigned.

Once the transaction is accepted, the appropriate acknowledgement transaction, including the DIA's board number, will be created and made available for pickup in the outbound FTP folder.

A FROI transaction can also be rejected by Claims Processing if it is determined to not be valid, in which case a rejection notification is sent back as an acknowledgement.

First reports of injury transactions that do not pass initial validation by the EDI process are automatically rejected and the appropriate acknowledgement is created.

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