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EDI Transaction Information

 



RI requires that both legal agreements and electronic EDI transactions be filed over the duration of a claim.  Legal agreements are submitted on paper. See Claim Forms for information on filing legal documents. See EDI website for more information on EDI transactions.

EDI Process: 

  • RI DLT uses the national standard, Claims Release 3, established by The International Association of Industrial Accident Boards and Commissions (IAIABC).

  • RI DLT mandated electronic filing on March 1, 2015.

  • The insurer or claim adjusting company handling the claim is known as the claim administrator.  The claim administrator gathers information on the claim and sends it electronically to RI DLT.

  • Injured workers and employers do not send a paper first report to RI DLT.  A worker reports an injury to the employer. The employer reports the injury to the claim administrator. The claim administrator reports electronically to RI DLT.

  • RI DLT has contracted with Insurance Services Office, Inc. (ISO) to manage electronic FROI and SROI reporting. ISO will register trading partners, conduct testing, collect EDI data and submit data to RI DLT.

  • Claim Administrators must register with ISO as a trading partner. Please complete a Trading Partner Profile.

  • For more information, visit the EDI website or contact ISO at ridltedi@iso.com.

EDI transactions:

  • First Report of Injury (FROI)
    • An injury must be reported if medical treatment is needed, if the injured worker is unable to earn full wages for at least 3 days, or if the injury is fatal.
    • Injured workers and employers do not send a paper first report to RI DLT.  A worker reports an injury to the employer.  The employer reports the injury to the claim administrator handling the claim.  The claim administrator reports injuries electronically to RI DLT.
    • No first report forms are accepted on paper.  

  • Subsequent Report of Injury (SROI):
    • A SROI is required when indemnity benefits START, STOP or CHANGE.
    • A SROI is required every 6 months to report the status of the claim (open or closed).  
    • A SROI reports the amount of benefits (indemnity and other) paid to date.

EDI requirements:

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4/18/20