Georgia § 62 - Electronic Date Interchange (EDI).

§ 62. Electronic Date Interchange (EDI).

Filing with the Board: Prior to filing in EDI, insurers, self-insurers, group self-insurers, and designated claims offices (TPAs) shall be certified to file via EDI by the Board. Insurers, self-insurers, group self-insurers, or designated claims offices (TPAs) shall file Forms WC-1, WC-2, WC-2a, WC-3 and WC-4 via EDI in form of FROIs (First Report of Injury) and SROIs (Subsequent Report of Injury). Any Form WC-1, WC-2, WC-2a, WC-3, or WC-4 that is filed in paper, by an insurer may be rejected by the Board and may subject the filing party to a penalty. When suspending benefits via EDI and an attachment to a filing or submission is required such as a medical report, or WC-240, the employer, insurer, shall mail to, or electronically file with the Board the required attachment prior to or simultaneously with the filing of the appropriate EDI transaction. Pleadings, forms, documents, or other filings shall be filed with the Board electronically through ICMS or EDI, unless otherwise authorized in these Rules. However, in the event of an outage preventing an electronic submission and the time for filing is at issue, the document may be filed in paper or by facsimile with any Board office. Any filing by facsimile transmission must be clearly labeled with the name of the claimant, claim number, and Board division or employee to whom the facsimile transmission is directed. The certificate of service, showing concurrent service upon the opposing party electronically or by facsimile transmission shall be a part of any electronic or facsimile transmission. Failure to include a certificate of service shall invalidate the filing. All facsimile transmissions must be identical to the originals and must be legible. The Board, within its discretion, may transmit documents by facsimile or electronic transmission. Changes in Handling of Claims: If an insurer, self-insurer, group self-insurer or designated claims office (TPA) adds, replaces, or terminates the services of a claims office, the trading partner agreement shall be immediately amended and updated. Compliance: If an insurer, self-insurer, group self-insurer, or designated claims office (TPA), files Form WC-1, WC-2, WC2a, WC-3, or WC-4 via EDI, then all subsequent FROIs (First Report of Injury) and SROIs (Subsequent Report of Injury) shall be filed via EDI. Failure to do so may subject the filing party to a penalty. Exceptions: Upon request, or on its own, the Board, in its discretion, may grant exceptions to this rule. Note as to Revisions. - This rule was added effective July 1, 2009. The revision effective July 1, 2011, added the last sentence in paragraph (1)(c); added "and may subject the filing party to a penalty" at the end of paragraph (1)(d); in paragraph (1)(e), substituted the first sentence for the former provisions, which read: "When filing via EDI, and whenever an attachment to a filing or submission is required, the employer, insurer, self-insurer, group self-insurer or designated claims office (TPA) shall simultaneously mail to, or electronically file with, the Board the filed Subsequent Report of Injury (SROI) or Form and a copy of such attachment." and inserted "simultaneously" in the last sentence; and rewrote paragraph (e)(3). The revision effective July 16, 2018, substituted "group self-insurers, or designated claims offices (TPAs) shall" for "group self-insurers, designated claims offices (TPAs) or their designated vendors shall" in paragraph (1)(b); deleted former paragraph (1)(c), which read: "Insurers, self-insurers, group self-insurers, and designated claims offices (TPAs) shall not file any document or submit any transmission via EDI in any claim created prior to July 1, 2009. For any claim created prior to July 1, 2009, insurers, self-insurers, group self-insurers or designated claims offices (TPAs) shall file documents in paper unless and until web filing is available. Upon approval of the Board, claims created prior to July 1, 2009, may be converted to EDI."; redesignated former paragraphs (1)(d) and (1)(e) as present paragraphs (1)(c) and (1)(d); deleted ", self-insurer, group self-insurer, or designated claims office (TPA) concerning any claim created on or after July 1, 2009" following "by an insurer" in paragraph (1)(c); rewrote paragraph (1)(d); added paragraph (1)(e); in paragraph (2), deleted ", and a Form WC-121 shall be filed with the Board." at the end; and in paragraph (3), substituted "group self-insurer, designated claims office (TPA), files" for "group self-insurer, designated claims office (TPA), or their designated vendor files" near the beginning.