Glossary Check: Texas Electronic Claim Data Request and Report

29 Mar, 2023 Frank Ferreri

                               

Austin, TX (WorkersCompensation.com) -- If you look around, you're bound to see the importance of data everywhere as well as the ubiquity of electronic forms and reports.

With those parts of today's reality in mind, Texas has built into its workers' compensation rules definitions for key vocabluarly terms related to electronic claim data requests and reports.

Here's a snapshot of how the Lone Star State has defined certain terminology:

Claim Data Report

The electronic report generated by the Division of Workers' Compensation in the format specified in the state's Claim Data Request and Report Implementation Guide.

Claim Data Request

The electronic request submitted by a requester in the formate specified by the Division in the Guide.

A claim data request must contain the following elements:

  1. All fields required in the applicable Guide.
  2. Complete, current, and correct values as described in the applicable Guide
  3. Records of persons who are or were valid members of the requesters' benefit programs and whose claims may be related to a workers' compensation claim.

A claim data request must be submitted by a requester.

Record

An electronic representation of one insured person containing a set of unique identifiers including the full name, date of birth, gender, and Social Security number, if available. Each set of individual identifiers included in a Claim Data Request represents a separate record.

Requester

An insurance carrier that has adopted an antifraud plan and qualifies as a carrier or its authorized representative.

Read up on compliance from around the U.S. on WorkCompResearch


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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.

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