WSI is soliciting proposals from vendors who will implement a turnkey electronic data interchange (EDI) process for workers’ compensation (WC) medical billing, medical documentation, and payment transactions. The objective of this initiative is to replace the number of paper filings with electronic transactions to improve the quantity and quality of data captured. WSI is expecting to outsource this service to multiple vendors who have successfully implemented WC EDI solutions for other states or payors. Expanding these capabilities with multiple vendors will expand utilization of this billing format by medical providers treating work injuries covered by the state’s workers compensation system. The International Association of Industrial Accident Boards and Commissions (IAIABC) established standards for WC EDI through a workers’ compensation model rule and companion guide, which incorporate ANSI ASC X12N standards. WSI expects the vendor to accommodate the standards outlined in these documents for EDI of medical billing, medical documentation, and payment transactions. A vendor must demonstrate the vendor is a member in good standing of the IAIABC and has actively participated in the EDI activities of healthcare and insurance providers for more than one year.
