Client story Risk compliance
Ebix Solution implemented — wcExchange
A filing is not finished when it is sent
A workers’ compensation team connected claim changes with validation, submission and acknowledgment handling.
Based on Ebix implementation experience. Client details have been omitted.
The submission queue was not the whole picture
A claims administrator supported workers’ compensation reporting across multiple jurisdictions. Changes to source claims created reporting activity, while submitted transactions produced acknowledgments or items requiring correction.
The team needed to distinguish what had been sent from what had been accepted. Without that distinction, a completed transmission could leave unfinished work outside the main view.
The workflow followed the claim change
The team used wcExchange to connect claim information with filing rules, validation and acknowledgment management. First and subsequent reports of injury were handled within the reporting process, with transaction history available for review.
The team connected the source change to the filing activity it generated. Assisted and automated steps had defined responsibilities, and exceptions remained assigned until the relevant work was complete.
A rejected transaction had a route back
The process included an incomplete record and a rejected submission. The operator examined the reason, identified the data requiring attention and distinguished the corrected transaction from the original.
Where the source claim also needed correction, that action remained part of the task. The team retained the sequence from the initial change through submission and acknowledgment, rather than keeping a separate explanation in an unconnected spreadsheet.
Unfinished work became visible
The operating view distinguished acceptance, rejection and items awaiting action. Acknowledgment management formed part of the reporting job, so sending the file did not automatically close it.
The value lay in the complete transaction record. The team could distinguish a submission from its acknowledgment, see unresolved items and follow a correction back to the relevant claim information.
Close the loop between submission, acknowledgment and correction.