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DEPT OF DEFENSE FECA Electronic Data Interchange (EDI)

DEPT OF DEFENSE FECA Electronic Data Interchange (EDI). WHAT IS EDI? EDI stands for Electronic Data Interchange. With EDI, CA-1 and CA-2 forms are submitted thru HRO, to the Department of Labor instantaneously, eliminating paper processing and mail delays.

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DEPT OF DEFENSE FECA Electronic Data Interchange (EDI)

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  1. DEPT OF DEFENSE FECA Electronic Data Interchange (EDI) • WHAT IS EDI? • EDI stands for Electronic Data Interchange. With EDI, CA-1 and CA-2 forms are submitted thru HRO, to the Department of Labor instantaneously, eliminating paper processing and mail delays. • The purpose of the EDI project is to expedite processing of FECA claims for injured workers. • Our goal is to have all CA-1’s and CA-2’s submitted within 10 days from the date of injury, and CA-7’s submitted within 5 days of the employees’ signature date. • Employees will be assigned a claim number within 48 hours of the time the claim is received by the Department of Labor. • Faster claims processing leads to expedited medical authorizations, treatment, bill payment. • Better service leads to faster recovery.

  2. EDI Information Flow • HOW DOES IT WORK? • Employee reports the injury to his/her supervisor IMMEDIATELY to complete a claim form. • Supervisor and employee complete the electronic form, Click PRINT, then SUBMIT, then form will be transmitted to HRO. • HRO “authenticates” the form (I.e., verifies employment status, enters appropriate codes, corrects any errors); form is then transmitted to DOL. • DOL assigns case number within 48 hours.Employee and HRO will receive a letter from OWCP stating whether the claim was accepted or denied, and the claim number.

  3. Medical Information • For CA-1’s ONE CA-16 should be issued IF medical attention is needed. Supervisors are not required to issue a CA-16 after 4 hours from time of injury. • Employees that receive medical care should tell the medical provider that it is FEDERAL Workers compensation and their claim number. All bills MUST be submitted on HCFA 1500’s or UB 92’s. No statements will be accepted. • OWCP has contracted out their billing to an agency called ACS. Medical Providers must be enrolled in ACS in order for bills to be paid. Providers can enroll by calling 1-866-335-8319

  4. The EDI Process • What are the requirements for participating in EDI? • Supervisor must have access to computer with internet connection. • Patience. It takes a few minutes for the forms to appear. • Where is the EDI web site? • The forms are accessible at https://isdmid1.cpms.osd.mil/web_html/static_java_edi_sup.html • The website is also located on the www.gahro.com under Forms and Publications. • A password is not required to enter a CA-1 or CA-2.

  5. The EDI Forms • The EDI forms are patterned directly on the hard copy forms CA-1 and CA-2. Therefore, the basic instructions for completing the forms are the same as with paper. A copy of these instructions can be obtained on-line at http://www.dol.gov/esa/regs/compliance/owcp/forms.htm • The electronic format does contain certain features that may require further explanation. The following slides illustrate some of these features.

  6. Step One: Enter employee’s SSN and date of birth. This information allows the system to access the employee’s personnel data. Step Two: Indicate whetherclaim is for a traumatic injury (CA-1) or an occupational disease (CA-2) If information is correct, click “enter.” This will take you to the next screen. If incorrect, reenter, or click “exit.”

  7. If you get this message, STOP. Go to www.gahro.com then to Employee Relations and complete the form. Then hand carry or mail to Georgia National Guard ERS: Kelly Casey 935 E. Confederate Ave. Bldg 21 PO BOX 17965 Atlanta, GA 30316

  8. PUBLIC JOHN F 999-99-9999 05/01/1960 The white fields are mandatory and must be completed by the employee. After completing each field, hit “tab” and the system will take you to the next field. When all required fields have been completed, the system will take you to the next screen, “injury description.” Yellow fields are optional, and should only be completed if appropriate Gray fields are read-only, and cannot be altered.

  9. The default value for this field is 12:00 a.m on the date the form is completed. Please enter the actual date and time of the injury

  10. Unless there is a specific reason for not electing COP (such as ineligibility), this block should be checked. The employee’s section of the document is now complete. Be sure to give employee the receipt of notice, which will print when form is complete.

  11. As with the paper CA-1, the witness statement is optional. However, if a witness statement is entered, the remaining fields on this page (name, date, address) are mandatory. Field is limited. Please ensure witness signs the printed form.

  12. Make sure that this date corresponds with the date of injury given by the employee.

  13. If the employee’s pay has not stopped, leave this field blank. If “no” is clicked, an explanation must be given in the box below. If “yes” is clicked, an explanation is mandatory.

  14. If “yes” is entered, you must enter at least the name of the third party in item 32. If the name is unknown, give a description (e.g. “homeowner,” or “driver”)

  15. If the supervisor has a substantial disagreement about the facts surrounding the claimed injury, click “no” and provide an explanation. Enter the reasons for controverting COP.

  16. Once all required fields have been entered, the supervisor must print a copy of the completed CA-1. This record must then be signed by the supervisor, employee, and witness then submitted to HRO for processing. EDI will tell you if there are any errors. If there are errors the form will take you to where you need to correct it. DO NOT FORGET TO CLICK SUBMIT AFTER YOU PRINT

  17. Now that the supervisor has printed a copy, the system will allow the claim to be transmitted. To transmit the record, click “submit claim.”

  18. Other Information • Please ensure that HRO or HRO Representatives receive ALL original signed CA-1’s or CA-2’s submitted. • Any employee who expects to enter a Leave Without Pay Status for Workers Compensation should be coordinating with HRO or HRO Representatives. • All original CA-1’s and CA-2’s will be maintained at HRO. • CA-7’s must be submitted to OWCP within 7 days of signature date. CA-7’s are currently not electronic. • Please make sure item 27, Date Employee Returned to Work is entered. If they were injured and returned to work the same day or the next day, put that day. • For Safety Reporting, follow your local safety directives.

  19. Additional Information If you need more information on Workers Compensation for the Georgia National Guard, please call Kelly Casey, 678-569-6431, DSN 338-6431 Or e-mail at kelly.casey@ga.ngb.army.mil

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