Workers’ Compensation Data Fields 2 Table of Contents Overview ............................................................................................................................................ 3 Data Accessed through the “Details” tab of the Summary page ........................................................ 3 Policy Type ...................................................................................................................................... 3 Jurisdiction Claim # ......................................................................................................................... 4 Denial .............................................................................................................................................. 4 Subrogation .................................................................................................................................... 5 Disputed Case/Controverted ........................................................................................................... 5 Data Accessed through the Claim Tree ............................................................................................... 7 Loss Information ............................................................................................................................. 7 Injured Worker ................................................................................................................................ 8 Primary Employer Data Fields........................................................................................................ 11 Medical Management Field ........................................................................................................... 12 Work and Benefit Status................................................................................................................ 12 Medicare .......................................................................................................................................... 13 Medicare Set Aside ....................................................................................................................... 14 MSA Settlement Process ............................................................................................................... 15 Conditional Payment of Medicare Lien .......................................................................................... 16 File Documentation for Medicare Lien .......................................................................................... 16 3TM Medicare Documentation in Claims .......................................................................................... 17 Deductible Recovery Module ........................................................................................................... 19 EDI Process ....................................................................................................................................... 20 FROI .............................................................................................................................................. 20 SROI .............................................................................................................................................. 21 Permanent Partial Disability / Maximum Medical Improvement ................................................... 25 Denial ............................................................................................................................................ 25 Settlement .................................................................................................................................... 27 State Specific Requirements .......................................................................................................... 27 3TM Automatic EDI diary triggers set in Claims ................................................................................. 29 Confidential, Proprietary and Trade Secret Document of NARS and protected by the Florida Uniform Trade Secrets Act, chapter 688, Florida Statutes. No use allowed unless specifically authorized.