DWC Announces Update to Insurance Carrier Scorecards

On February 2, 2024, Ms. Tammy Campion, Deputy Commissioner for Business Process, announced that DWC has updated the Insurance Carrier scorecards for August 2023 through December 2023 with Texas Claim EDI Release 3.1.4 data.

They can be accessed at https://www.tdi.texas.gov/wc/carrier/index.html

Reminder about Scorecards
Ms. Campion urged Carriers to remember that scorecards are entirely based on EDI data that Insurance Carriers report to DWC. These reports are snapshots, they are not refreshed after they are posted. Timeliness is calculated in accordance with the applicable rules.

Further, she stated that Insurance Carriers should use these reports to monitor for possible EDI reporting issues. Insurance Carriers are encouraged to work with their agents and EDI compliance coordinators to improve the timeliness and accuracy of EDI reporting.

Timely Initial Payment (IP) of Temporary Income Benefits (TIBs)
Ms. Campion also noted that an IP for TIBs (DN0085 BTC 050 and 070) is timely if the payment date (DN0195) is within:

• • • 15 days of the claim administrator being notified about the claim (DN0041); or
    • 7 days after the benefit accrual date (DN0297).

Timely Reporting of IP of TIBs
Further, reporting of an IP for TIBs (DN0085 BTC 050 and 070) is timely if the EDI report is received within 10 days of the payment date (DN0195).

Detailed Claim Data for August 2023 through January 2024
Finally, Ms. Campion stated that Insurance Carriers with standing requests for detailed claim EDI data will get data for August 2023 through December 2023 in their SFTP boxes in the next few days. Insurance Carriers that would like to receive EDI data should file a DWC Form-029, Request for Standard Detailed Data Reports.

If you have any questions or to provide input, please contact edisupport@tdi.texas.gov or James Sheffield, Managing Shareholder, at jrs@fol.com.