compliance. solutions
Something as regulated, regimented, & defined as compliance should be built into a solution in an automated, task centric fashion.
We apply this principal to State, Federal, and even custom auditing processes.
FROI SROI EDI
PCIS’ award winning solution for State EDI reporting of FROIs and SROIs, is called “No Touch FROI SROI Reporting”. It is a proprietary solution that entirely automates the reporting process allowing the RMIS or Claims system to trigger State activation points and then automatically code, populate, pre-validate, and transmit to State.
Permanent Disability
Permanent disability rating for the most part, is an art, not a science. The rating process requires human judgment, discernment and technical skill. With PCIS’ GenrRATE Commutation application, calculating is fool proof. This is the ONLY solution on the market built with the State, and therefore produce notes/reports that are admissible in CA Court.
Medicare Reporting
The ClaimsVISION System exports a quarterly Claim Input File to the COBC to report workers’ compensation claim information based on specific mandated reporting requirements. The ClaimsVISION System imports a quarterly Claim Response File after the COBC has processed the Claim Input File. ClaimsVISION Data is updated based on the information received in the Claim Response File. ClaimsVISION has is ICD10 compliant and offers quick references for claim centric searches.
OSHA Reporting
ClaimsVision captures OSHA-related fields along its claims-centric workflow, and includes flagging to denote claims as OSHA reportable, and generates several OSHA reports such as OSHA301A, OSHA300A, and OSHA Summary reports.
ISO Claim Search
ClaimsVISION is pre-integrated with Bi-directional ISO Claims search. Upon claim submission, ClaimsVISION ping’s ISO searching the database and returns information about other claims filed by the same individuals or businesses (either as claimants or insureds). The system searches for matches in identifying information fields, such as name, address, Social Security number (SSN), vehicle identification number (VIN), driver’s license number, tax identification number (TIN), or other parties to the loss.
OFAC Checking
ClaimsVISION leverages a pre-integration to ISO’s OFAC Compliance Service is available as an option to ISO ClaimSearch subscribers. The service uses the existing infrastructure of ISO ClaimSearch to let you search your daily claims against the OFAC watch list without having to make a special submission. If the system finds a match, we’ll notify your designated company representative by e-mail.
ClaimsVISION FROI/SROI
PCIS is in tune with technological advances in the industry and we are always searching for ways to improve our services by upgrading our software for the benefit of our customers. It is with this in mind that PCIS has partnered with ISO and has pre integrated with their Injury reporter application. Our customers will recognize significant benefits, which are outlined:
- ISO is already working with 37 States for electronic reporting of FROIs and SROIs.
- Direct access to the Injury Reporter application is provided to all PCIS customers to view, query and make corrections as needed.
- PCIS’ interface with ISO validates data before it gets reported to the State, eliminating errors and fines.
- PCIS charges per claim no matter how many reports need to be transmitted.
- PCIS’ interface with ISO is more robust and automated, saving significant time and ultimately cost.
Permanent Disability Rating
Permanent disability rating for the most part, is an art, not a science. The rating process requires human judgment, discernment and technical skill. However, rating disabilities can be tedious and time consuming, requiring you to perform similar calculations time and time again. There are many cross-reference tables that can potentially cause errors. Also, non-scheduled ratings constitute the majority of ratings performed in the rating industry.
GenRATE solves these problems by performing these calculations in an error proof, consistent manner. This feature, combined with an ability to inject subjectivity and non-scheduled rating assistance, makes GenRATE an invaluable tool in the workers’ compensation field. GenRATE provides assistance to all members in the workers’ compensation field. Attorneys can greatly benefit from GenRATE’s rating calculations in a timely and efficient manner. Insurance agencies can benefit as the dollar value from permanent disability ratings can be determined for reserving purposes. The commuted value of the dollar amount can also be determined at any interest rate.
GenRATE is designed to assist the inexperienced and experienced user alike. Step-by-step instructions are provided in this manual, along with specific examples, support documentation and worksheets used in determination of the final rating. GenRATE can be an excellent tool for those entering the rating field.
The GenRATE software package has been designed with state-of- the-art technology. All routines are programmed in the “C” language and provide timely, accurate and comprehensive ratings. The valuable assistance of many reference materials and members of the workers’ compensation society are recognized in the development of the GenRATE package.