CLAIMS AND REGULATORY DATA SYSTEM

**Check back often for the latest information and updates.** 

 

ATTENTION ALL INSURERS/TPAS

THE DEADLINES FOR THE FLAT FILE DEVELOPMENT AND GRACE PERIOD HAVE BEEN EXTENDED. 

We have discovered an issue with reopen/closures that needs to be corrected prior to accepting any flat file submissions from our stakeholders.  It is currently being worked on with our vendor and that information will be provided to stakeholders for development once testing has concluded.

 

Insurers/TPAs who choose to use the Flat File to index claims will be given a grace period until January 1, 2018 to index any claims that were not indexed prior to March 24, 2017*. 

The Flat File must be ready for testing beginning November 1, 2017.  Testing and any corrections to the Flat File must be completed by December 1, 2017 and the Insurer/TPA must begin indexing all claims. 

Any stakeholder is welcome to develop the Flat File at any time going forward.  However; there will not be a grace period for claims indexing beyond the dates listed above.

 

*This does not include claims that will be transferred to another administrator or claims office.  All transferred claims are required to be indexed prior to the transfer.

Submission and Requesting Claims Requirements Version 3.0

D-38 Manual Version 3.0

D-38 CLAIMS INDEXING

June 6, 2017: The D-38 Form has been updated for ease of use. There are no new data elements or requirements, just an improved layout. 

Save completed forms as .pdf documents and email to indexing@business.nv.gov.

• Download the updated D-38 Form:   D-38 Claims Indexing Form  

 

WCS will be hosting a D-38 Claims Indexing training on June 15, 2017 at 9:30am. Watch for an email notification with registration information.

 

 

CARDS IS LIVE!!

External Administrators are now able to register in the portal.   Go to https://cards.nv.gov and click on the "Register Today" button.  

You will receive an email to activate your account. After you have activated your account, send an email to cards@business.nv.gov with the following information: 

 * Insurer or TPA Name(s)

 * Nevada Certificate of Authority or License Number(s)

 * Your Name and Email Address

Once you have been added as an External Administrator, you will receive a confirmation email.  You can then begin using the system and adding individual users and granting permissions.  (Individual users will follow the same registration process once they've been added by the External Administrator.) 

 

****DATES TO REMEMBER****

 

Please refer to the External System User Manual for additional information or email cards@business.nv.gov with your questions.

 

Options for Claims Indexing

 FLAT FILE – Insurers/TPAs who choose to use the Flat File to index claims will be given a grace period until October 30, 2017 to index any claims that were not indexed prior to March 24, 2017.  The Flat File must be ready for testing beginning September 1, 2017.  Testing and any corrections to the Flat File must be completed by October 1, 2017 and the Insurer/TPA must begin indexing all claims. 

 PAPER FORM – The **NEW** paper Claims Indexing Forms (D-38) will be available beginning March 27, 2017 but will be phased out within the next 12-18 months.  Insurers/TPAs who choose to use this method can immediately begin indexing claims using the new paper forms.  There is no grace period for submitting paper forms.       

 WEB PORTAL – The CARDS portal will launch April 11, 2017.  Insurers/TPAs who choose to wait until the launch date to index claims via the portal will be given a grace period until April 30, 2017 to index any claims that were not indexed prior to March 24, 2017.

CARDS External User Manual

• Download the External User Manual:   CARDS External System User Manual  

 Print the manual and bring it with you to the training session.

Reporting Triggers and Deadlines

INITIAL REPORTS:

Within 30 days of  

  • Claim Determination (Acceptance or Denial of Claim) 

UPDATES: 

Within 30 days of any of the following

  • Benefit Start Date, End Date or Type Change (TTD, TPD, PPD, Rehab, PTD)
  • Change in Claim Determination (Denial to Acceptance or vice versa)
  • Claim Type Change (Med Only to Lost Time/Indemnity)
  • Change to/from Catastrophic Claim status
  • Finalized PPD rating and award offer
  • Claim Closure
  • Claim Reopening
  • Injured Employee Death
  • Any correction to or update of the Injured Employee’s Information including name, gender, birthdate, SSN, employer, etc
  • Any correction to or update of the Claim Information including claim number, date of injury, nature of injury, cause of injury, type of loss, body parts involved, etc.

Flat File Format/Data Elements

Insurers and TPAs will be able to submit D-38 Claims Indexing data for individual claims via the web portal or in bulk via flat file. This also includes all of the codes being used in Nevada.

• Download the Claims Flat File Format:   D-38 Claims Flat File Format

 

Please direct questions to the WCS CARDS Project Manager, Stephanie Canter, at (702) 486-9091 or to CARDS@business.nv.gov.