The Workers Compensation Insurance Organization (WCIO) approved the recommendation of the Electronic Data Interchange (EDI) subcommittee and the request by the Workers Compensation Rating and Inspection Bureau of Massachusetts (Bureau), to add a business segment field (Business Segment Identifier) to the electronic header record of each Policy and Unit Statistical Report. This field allows carriers the option to provide a coding device to the Bureau, to use for identifying any subset of that carrier’s policy or USR data. The insuring carrier can provide or limit access to the data identified with the business segment in the Bureau’s Members Area product, Manage USR.
This PowerPoint is a presentation made to the WCRIBMA Data Reporting Committee.
13. Current Members Area Security Limitations Carrier Group A (Carrier IDs – A1234, A5678, A2468) Searches Return ALL Carrier Group A’s DATA Carrier Group A A1234 A5678 A2468 Search
14. New Members Area Security Benefit Business Segment XYZ (Business Segment ID – 98765 Searches Return ONLY Carrier Group A’s DATA containing Business Segment ID 98765 Carrier Group A A1234 A5678 A2468 Search
15. Comparison of Data Access Control BEFORE AFTER More Secure Carrier Group A Carrier Group A A1234 A1234 A5678 A5678 A2468 A2468
16. Part Two What do I need to do to use the Business Segment ID?
18. Create Business Segment and User Smedley has been ‘converted’ to Bus Segment User in Business Segment XYZ with Business Segment ID 98765 New This option adds a new Business Segment to the Group. Choose to ‘convert’ existing Users to Bus Segment User simply by changing their Role or Create a Bus Segment User from scratch
19. Ensure Business Segments Report ID Report Business Seg ID 98765 in HEADER RECORD (BUSINESS SEGMENT IDENTIFIER Field) as per WCIO Manual Spec Report Business Seg ID 98765 in HEADER RECORD (BUSINESS SEGMENT IDENTIFIER Field) as per WCIO Manual Spec
20. Grant Access to Bus. Seg. Ready Products Smedley can now use New Manage USR to access units reported with Business Segment ID 98765 Business Segment User functionality is available in Manage USR and Manage Policy (Coming Soon) New Manage USR
22. New Manage USR – Business Segment Unit Group A XYZPolicy 2020151 98765 Hammer and Tongs Plumbing
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Editor's Notes
This is an opportunity to introduce the Business Segment Identifier and highlight its presence in the WCIO Manuals. Some key characteristics of the element, as the manual mentions, are that it is maintained and reported by the data provider.
This is a simplified overview of the data reporting process. It introduces Carrier Group A and highlights the fact that Carrier Users and TPAs are a singular entity as far as the process is concerned. In much of this presentation a TPA is being used as the Business Segment. However, the TPA is only one example of how the Business Segment might be utilized and a later slide will touch upon some other potential usages.
This detail further illuminates the fact that Carrier Users and TPAs currently have access to the same data set in our database using a Manage USR Search and a quasi Venn Diagram. First pointing out the limitations in the current data reporting process helps to later illustrate the benefits that can be had by utilizing the Business Segment ID.
This demonstrates the benefit of being able to limit the data that a Business Segment User is able to access through products in our Members Area.
First must define the Business Segment subset and assign with a segment id and then assign specific users to the business seg within the Members Area. Ensure that the Business Segment are reporting with the appropriately assigned Bus Seg ID. The Bus Seg Users that have been assigned to each bus seg id will then need to be granted access to the Bus Seg ready products, which are and will be going forward MUSR, MPolicy, and WCRATINGS.
Demonstrates User SmedleyMucklethorpebeing ‘converted’ from a User to a Bus Segment User and adding Business Segment XYZ with Business Segment ID 98765
Once reported on the policy and policy revisions the business seg id will show on the UST system within Manage USR and will list those units and corrections that are needed. Once the USRs are reported if needed they can be verified in the edit verification within MUSR.