CLAIMS AND REGULATORY DATA SYSTEM
**Check back often for the latest information and
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
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
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.
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 firstname.lastname@example.org.
• 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 email@example.com 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 firstname.lastname@example.org 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.
Reporting Triggers and Deadlines
Within 30 days
Determination (Acceptance or Denial of Claim)
Within 30 days
of any of the following
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)
to/from Catastrophic Claim status
- Finalized PPD rating
and award offer
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.