Mastering data compliance reporting requirements for 
workers’ compensation

Workers’ compensation data compliance reporting is challenging; insurers must carefully format and submit detailed claim and policy data to state jurisdictions and data collection organizations. Verisk has solutions for all workers’ compensation compliance reporting needs that will help save time and improve reporting accuracy.

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Simplify workers’ compensation reporting with the EDI Reporting Map

Navigating the complexities of workers’ compensation state reporting is extremely challenging. Each state has a rating board that collects both policy and claim data for experience rating and a state jurisdiction board that collects policy data to establish proof of coverage and claim data to verify that claimants are receiving appropriate benefits. Managing numerous compliance reporting obligations can be overwhelming, especially when working through technical challenges in EDI states. If you struggle to keep up with each jurisdiction’s specifications, we have a tool that can help: the EDI Reporting Map.

Download Map

Insurers can handle workers’ compensation reporting with wcPrism®

wcPrism is a complete suite of workers’ compensation data compliance reporting products for insurers. The component solutions include:

  • Injury Reporter — Satisfies states’ Electronic Data Interchange (EDI) electronic compliance requirements for first and subsequent reports of injury (FROI/SROI) with accuracy and confidence
  • Unit Statistical Reporter — Meets data collection organization (DCO) requirements for aggregation and valuation of policy and claim data for the submission of unit statistical reports (USRs)
  • Detailed Claim Information (DCI) Reporter — Meets DCO requirements for reporting specific claims data elements for randomly sampled claims
  • Policy Reporter — Meets DCO and state jurisdiction requirements for reporting policy information (WCPOLS) to individual DCOs and proof-of-coverage information (POC) to state jurisdictions to avoid noncompliance fines
  • Medical Reporter — Consolidates medical bills into one data warehouse to manage compliance reporting for all DCOs
  • Indemnity Data Call — Meets requirements for aggregation and valuation of indemnity claim data for the submission of the indemnity data call to the DCOs

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Now supporting NCCI’s new call for indemnity data

The National Council on Compensation Insurance (NCCI) announced that new data reporting for indemnity benefit payments will be required in 2020. Data reporters will need to report additional data elements for indemnity benefit payments. wcPrism meets requirements for aggregation and valuation of claim data for indemnity claims. Read more on our blog.

For more Verisk workers’ compensation solutions, check out:

wcAnalyzer™

Provides states and insurers with the means to turn untapped data into actionable insights


wcCapture™

A workers’ compensation data collection system for states


wcNavigator®

Detect and manage high-severity workers’ compensation claims through predictive analytics


Medicare Future Allocations

Medicare Set-Asides and cost mitigation


ISO Claims Partners

Helps insurers take control of claims, compliance, and costs


Workers’ Compensation Claims Management

Manage complex claims and reporting requirements