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EDI Crossover Documents

The following EDI Release 3 crossover documents are being provided to assist with the implementation of Claims EDI Release 3 filing requirements. Submit any comments, questions and suggestions you have regarding the guide to the Bureau’s EDI section via the Customer Service “Submit a Question” feature from the WCAIS Dashboard.

Note: Please continue to check for the posting of additional scenarios/revisions.

LIBC-336 LIBC-337 LIBC-338 LIBC-339
 
LIBC-340 LIBC-380 LIBC-392a LIBC-494c
 
LIBC-495 LIBC-496 LIBC-498 LIBC-501
 
LIBC-502 LIBC-751 LIBC-755 LIBC-757
 
LIBC-761 LIBC-762 LIBC-763 LIBC-764

EDI Forms Solution DN Mapping

The following EDI Forms Solution Data Element (DN) Mapping reference documents are being provided to assist filers with determining the appropriate EDI fields to populate to ensure accuracy in form filing.

LIBC-495 DN Mapping
 
LIBC-496 DN Mapping
 
LIBC-501 DN Mapping
 
LIBC-502 DN Mapping