C T onable o North American Risk Services, Inc. t en tsf Workers’ Compensation CLAIMS FILE DOCUMENTATION EXPECTATIONS NARS W a EDI/STATE FILINGS y UW Expectation: All form-work should be completed by the specific jurisdiction time frame. All EDI requests should be nit MC C completed within 48 hours of the requirement. EDI is required to have form-work completed within 48 hours of the anagr request. edo f eror Example: (just one line of the specific form) s f orW • Filed FROI with State of Iowa 11/08/2020. SC C • IP filed with State of Iowa on 11/10/2020. pecialistsr • S1 filed with State of Iowa on 11/14/2020. edo • FN filed with State of Iowa on 11/30/2020. *Attach document. P r acticB esest MEDICARE • Is the injured worker a Medicare recipient? U • Fill in the information on the Medicare Tab under the Injured Worker tab on the tree. Checklistnit M • Fill in HICN #. anag • ORM Assumption Date (Check ORM Accepted): If the claim is or is projected to be greater than $750 in medical. er • Choose ICD Codes from your list. • See Closure for requirements for Medicare when closing a claim. S W Checklistpecialist C Claims Note Example if a conditional payment notification is received: The injured worker is a Medicare recipient with HCN: 45324A432. The file has now been settled. TPOC entered on 11/08/2020. 14 DExpecta F Conditional Payment Notification received. Information was sent to (Cattie & Gonzalez) to assist in the lien. a tionsile y Received Conditional Payment Ledger for $24,000.00. s *Must notify your leader, and the leader must document acknowledgment and agree with the direction. Expecta F tionsile R e f erD encisability e G uide CaN t o egt orieses and 20 21