The bureau's acceptance of EDI transactions is contingent upon a properly completed Trading Partners Profile, successful testing, and executed Trading Partner Agreement. The bureau will notify new partners when these requirements have been satisfied.
Companies interested in using EDI must complete and return the information requested in each of the documents listed below. Additional information may be obtained by contacting the bureau's EDI Section via the customer service "Submit a Question" feature from the WCAIS dashboard.
The Bureau of Workers' Compensation requires all trading partners to submit EDI transactions to the bureau using one of its approved EDI transaction partners. The bureau will verify that each EDI transaction partner is qualified to send and receive data utilizing the IAIABC EDI Release 3 format that meets the requirements set forth by the EDI Questionnaire
, the Transaction Partner Testing Requirements
document, and within the bureau's Claims EDI Implementation Guide. All requests to be added to the list of EDI transaction partners must include a completed copy of the EDI Questionnaire attesting to the ability to meet all transaction partner requirements.
The bureau requires all trading partners to submit EDI transactions using one of its approved EDI transaction partners. Only EDI transactions coming from these organizations will be accepted.
The basic requirements for becoming an approved EDI transaction partner in Pennsylvania are:
Organization must be in the business of trading in EDI Claims Release 3 on behalf of others.
Organization must have experience trading in IAIABC Claims Release 3 format in other jurisdictions.
Organization must be able to supply a data feed in either flat or XML format (as specified by L&I).
Organization must provide an online portal option to allow small businesses to submit EDI data.
Organization must be an active IAIABC EDI member.
If, after testing, it is determined that a transaction partner cannot process data as required or has not maintained standards set forth in the Transaction Partner Testing Requirements
document, Implementation Guide and Appendices, it may result in dismissal as an approved transaction partner. Any transaction partner dismissed from the list will have to re-apply through the standard process to again become an approved EDI transaction partner. All transaction partners agree to comply with testing time frames as outlined by the bureau.
Approved EDI Transaction Partners
Business address: 10 Tenth Street, NE, Atlanta, GA 30309-3848
Contact: Kevin Newlin
Contact telephone number: 404-418-9886
Contact email address: Kevin.Newlin@ebix.com
Business address: 11730 W. 135th Street, Suite 31, Overland Park, KS 66221
Contact telephone number: 913-764-9347 x112
Contact email address: email@example.com
Insurance Services Office Inc.
Business address: 545 Washington Boulevard, Jersey City, NJ 07310
Contact: Larry Travaglia
Contact telephone number: 201-469-2337
Contact email address: firstname.lastname@example.org
Mitchell Workers' Compensation Solutions (WCS)
Business address: Mitchell International Inc. (corporate office), 6220 Greenwich Dr., San Diego, CA 92122
Contact: Kyle Devereaux, Sales Executive
Contact telephone number: 858-368-7593
Contact email address: Kyle.Devereaux@mitchell.com
Aerie EDI Group
Business address: 315 Kennedy Road, Chase City, VA 23924
Contact: Pat Cannon
Contact telephone number: 434-509-4494
Contact email address: email@example.com
A trading partner can submit EDI transactions directly to the bureau by placing their files at the Department of Labor & Industry's SFTP location without using a transaction partner. Trading partners must fulfill the direct filer's criteria
and complete all testing requirements successfully.
NOTE: The testing window for direct filers is currently closed and will reopen at a later date. New requests for direct filing status in PA, submitted along with the required direct file documents, are added to the list of direct filers to be tested at a later date. (Requests submitted without the required documents will be returned not processed.) When the testing process reopens, applicants will be contacted in the order requests were received.
Updated documents including the Direct Filer/Trading Partner Criteria, PA Claim Administrator Address List, PA Claim Administrator ID List, PA Transmission Profile, and PA EDI Trading Partner Agreement can be found above
In the interim, insurers have the option to use one of the existing EDI-approved transaction methods including the EDI claims Web portal or one of the approved EDI Release 3 transaction partners.
Questions can be directed to the bureau's EDI Section via the customer service “Submit a Question” feature from the WCAIS dashboard.
Companies may submit a request to add a new business unit (or several) to their profile in WCAIS if new offices have been added. Additionally, parent companies with multiple subsidiary organizations may submit a request to add new subsidiary organizations.
, which describe the steps necessary to request the new associated business unit or subsidiary organization, can be found on the "Insurer and TPA Training Resources" page. Click the following link and scroll down to the section Key Communications and Helpful Documents