DOI Proposed WC EDI Standards

The Illinois Department of Insurance's proposed-rules for workers' compensation electronic claims submission and payment standards appeared in the Illinois Register this morning. 
 
The publication of these proposed rules means that they are now in the Illinois General Assembly's Joint Committee on Administrative Rules' First Notice phase.  Any interested party or member of the public has 45 days from this publication date to submit any questions, issues, or concerns to the Illinois Department of Insurance regarding this rulemaking.
 
From the published proposed rulemaking (PDF pages 5-23):

A Complete Description of the Subjects and Issues Involved: This rule is required to implement the electronic claims provisions contained in Section 8.2a of the Illinois Workers' Compensation Act [820 ILCS 305/8.2a]. The focus of this proposed rule is to provide a legal framework for electronic billing, processing and payment of medical services and products provided to an injured employee and data reporting subject to Section 8.2a.
 

The EDI standards included in the rulemaking cover various types of provider bills, specifically

• Professional billing
• Institutional/Hospital billing
• Dental billing
• Retail Pharmacy billing

The listed IDOI contacts for public comment submission are:

Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Persons who wish to comment on this proposed rulemaking may submit written comments no later than 45 days after the publication of this Notice to: 

         

          Joe Clennon, Staff Attorney
          Illinois Department of Insurance
          320 West Washington St.
          Springfield, IL 62767-0001
          217/557-1396
          217/524-9033 (facsimile)

 

          Susan Anders, Rules Coordinator
          Illinois Department of Insurance
          320 West Washington St.
          Springfield, IL 62767-0001
          217/785-8220