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Online System for Claims Administration Research/Regulation (OSCAR)

Online System for Claims Administration Research/Regulation (OSCAR) is a comprehensive online Workers Compensation management system that went live in November 2018.

With the implementation of this system we have gone completely digital, and nearly all submissions to the Division are now required to be in OSCAR. This includes:  Applications for Benefits/E1’s and all filings related to cases, appeals, and undocketed settlements; Records Requests; Elections; Paid Loss Reports and Assessment Invoices; Self-Insurance Applications and supplemental materials for self-insurance; and proof of coverage for Compliance related issues. Users will have access to the system 24 hours a day and 365 days a year except for brief maintenance periods. OSCAR also provides immediate access to track submissions, cases, and outcomes.

If you have any further questions, please contact the OSCAR support team at kdol.oscar@ks.gov.

Note: The Workers’ Compensation statute (44-566a(c)(1)) requires that the commissioner of insurance must receive written notice from a party wishing to implead the workers compensation fund, setting forth the nature of the liability asserted.

If you are filing a motion to implead the fund in OSCAR the Fund is not automatically added as a participant on the case and will not receive notice through the system. Once they have been added to the case then OSCAR will notify them through the system. Please send your written notice to the Fund at Kansas Insurance Department, Workers’ Compensation Fund, 1300 SW Arrowhead Rd, Topeka, KS, 66604-4073.

Kansas Electronic Data Interchange (EDI)

With the successful conclusion of the XML claims pilot project Kansas will cut over to the new IAIABC XML 3.1 Claims standard beginning Monday April 19, 2021. All trading partners associated with our pilot partners, Mitchell & Aerie EDI Group (EDI) will cutover on this date.

Any current trading partner submitting the flat file 3.1 claims format (Kansas allows both the ACORD/IAIABC XML and flat file 3.1 claims currently) may move to the new XML format after April 19, 2021 and upon completion of full XML testing.

Please contact David Sprick or Kansas EDI Coordinator at Ebix if you have any questions or need further information.

KS EDI 3.1: On November 29, 2018, Kansas implemented EDI Release 3.1. The Kansas EDI 3.1 release date coincides with go-live of Kansas’ Online System for Claims Administration Research/Regulation (OSCAR). Kansas EDI data will be integrated into OSCAR and some of the new requirements in claims 3.1 are needed to support OSCAR functionality and processes.

Requirements Tables

Trading Partner Documents

Note: Please contact Ebix to set up testing at (866) 448-1776 or KS-EDICoordinator@Ebix.com. EDI vendors that are already submitting in at least one R3.1 EDI state at the time of testing are only required to complete connectivity testing requirements.

KS EDI 3.0 Migration to 3.1 (Open and Re-opened Claims)

  • Kansas R3.1 FROI UR Trigger - Any open or reopened claim previously reported via IAIABC R3.0 prior to 11/29/2018. Must be sent prior to submitting any other First Reports of Injury for claims that were initiated before implementation of R3.1
  • Kansas R3.1 SROI UR Trigger - Any open or reopened claim previously reported via IAIABC R3.0 prior to 11/29/2018. Must be sent prior to submitting any other Subsequent Reports of Injury for claims that were initiated before implementation of R3.1
  • Kansas R3.0 Migration Claim Submissions - Kansas expects the FROI UR and SROI UR submissions for R3.0 migration claims to be completed by January 11, 2019

Statutes 

44-557a. Compilation and publication of statistics; database of information; submission of data; contracts for actuarial or statistical services. (a) The director shall: (1) Compile and publish statistics to determine the causation of compensable disabilities in the state of Kansas and (2) compile and maintain a database of information on claim characteristics and costs related to closed claims, in order to determine the effectiveness of the workers compensation act to provide adequate indemnity, medical and vocational rehabilitation compensation to injured workers and to return injured workers to remunerative employment. The commissioner of insurance shall cooperate with the director and shall make available any information which will assist the director in compiling such information and statistics and may contract with the director and the secretary of the department of health and environment to collect such information as the director deems necessary. The secretary of revenue shall cooperate with the director and shall disclose individual income taxpayers names, addresses and social security numbers to the director to be used solely for the verification of workers compensation data files. For purposes of this subsection, such disclosure shall not be considered the disclosure of any particulars of a report or return

(b) In order to further the purpose of subsection (a), each self-insured employer, group-funded workers compensation pool and insurance carrier shall submit to the director the disposition of a statistically significant sample of closed claims under the act. Unless provided by regulations to the contrary, on or after January 1, 2004, any insurer, group-funded workers compensation pool or self-insured employer who voluntarily submits claim information to the director pursuant to release 1 of the international association of industrial accident boards and commission’s electronic data interchange implementation guide dated August 9, 1995, and amendments thereto, up to April 4, 2002,

(c) Each self-insured employer, group-funded workers compensation pool, insurance carrier or health care facility shall submit medical information, by procedure, charge and zip code of the provider, or by hospital charge and related diagnostic and procedure codes in order to set the maximum medical fee schedule

(d) The director may contract for professional actuarial or statistical services to provide assistance in determining the types of information and the methods of selecting and analyzing information as may be necessary for the director to conduct studies of closed claims under the workers compensation act and to enable the director to make valid statistical conclusions as to the distribution of costs of workers compensation benefits

(e) The director shall obtain such office and computer equipment and employ such additional clerical help as the director deems necessary to gather such information and prepare such statistics

(f) If a self-insured employer, group-funded workers compensation pool or insurance carrier fails to supply the information required by this section, the director shall issue and serve upon such person a summary order or statement of the charges with respect thereto and a hearing shall be conducted thereon in accordance with the provisions of the Kansas administrative procedure act. An administrative penalty of up to $500 for each violation or act, along with an additional penalty of up to $100 for each week thereafter that such report or other information is not provided to the director shall be imposed

History: L. 1974, ch. 203, § 44; L. 1993, ch. 286, § 60; L. 1997, ch. 125, § 14; L. 2000, ch. 160, § 17; L. 2002, ch. 122, § 5; July 1; L. 2003

Administrative Regulations

This report primarily serves as a method for trading partners to monitor the quality of their reporting to the Division, providing the opportunity to address potential issues and to improve data quality. A secondary reason is to ensure compliance with the Division’s quality standard.

Beginning July 1, 2004, the Division formally implemented its data quality standard for the EDI program. The quality standard is as follows: a minimum of 85% of all FROI/SROI reports per quarter are accepted with a TA or TE status and no more than 15% of all reports are rejected with a TR status.

EDI Quality Report

The Reports linked below will take you to an Excel spreadsheet file containing two worksheets: ‘Quality’ and ‘Uncorrected Errors.’

The ‘Quality’ sheet contains the quality data for each trading partner. The columns of this sheet are organized as follows: trading partner name, TA count, TE count, number of uncorrected TE reports, TR count, TA percentage, TE percentage and TR percentage. The percentages are based on total reports sent per trading partner for the quarter. Compare these percentages to the quality standard stated above to determine if any action on behalf of the trading partner is required (see action items below).

If you have any uncorrected TE counts, please see the 'Uncorrected Errors' sheet to see which claims contain the TE. Please make corrections using a CO report as soon as possible. All TE reports should be corrected (see action items below).

Action Items: Use the quality data to compare to the standard to determine what following action is required on behalf of the trading partner.

  1. If your quality report meets or exceeds the Division’s quality standard, then nothing is required
  2. If your quality report is below the Division’s quality standard, please submit a response to the Division within five business days of receipt of the notification email that the quality report is available. This response should contain a brief and general description of the circumstances that led to the errors listed in this report (e.g., new employee, new software, hardware issues, etc.) and any action taken to resolve those issues
  3. If you have any outstanding TE reports that need correction, please do so immediately

Previous EDI Quality Reports 

TA/TE/TR Counts by Trading Partner will take you to a series of tables and graphs that can be interactively changed by the user, based on a particular year and quarter within that year. This will allow Trading Partners to see their yearly trends regarding EDI Reporting compliance. You can also find each table/graph, as well as counts of TAs, TRs, and TEs by quarter, listed individually at the bottom of the page.

2019 Reports

2018 Reports

For business/law/regulations issues and questions, please contact:

401 SW Topeka Blvd, Suite 2
Topeka, KS 66603-3105

401 SW Topeka Blvd, Suite 2
Topeka, KS 66603-3105

For the Kansas EDI Coordinator and KWC Vendor Help Lines at Ebix, please contact (866) 448-1776 or (614) 877-2501 (FAX), or KS-EDICoordinator@Ebixrisk.com.

For the International Association of Industrial Accident Boards and Commissions (IAIABC), please contact (608) 633-6355 or visit the IAIACB website.

For the U.S. Department of Commerce U.S. Census Bureau North American Industry Classification System (NAICS), please visit the NAICS website. Please note that Kansas accepts the 2017 codes only.

The following is a list of EDI vendors currently submitting workers compensation claim reports in other jurisdictions and have proven technical and business capability to comply with the Kansas EDI Implementation Guide. This list is for informational purposes only and KDWC does not endorse and/or recommend the services of any one vendor.

Refer to the IAIABC and other EDI standard setting organizations for additional EDI vendors.

Mitchell Regulatory Reporting Solutions

Kyle Devereaux, Sales Executive
kyle.devereaux@mitchell.com

6220 Greenwich Dr
San Diego, CA 92122

Ebix

Shayne Garner
shayneg@ebix.com

1 Ebix Way
Johns Creek, GA 30097

Insurance Services Office, Inc.

545 Washington Blvd.

 Jersey City, NJ 07310 

HealthTech

19834 Kershaw Ct
Monument CO 80132

Riskonnect

1701 Barrett Lakes Blvd, Suite 500
Kennesaw, GA 30144

Aerie EDI Group "AEG"

315 Kennedy Rd
Chase City, VA 23924