Insurance Match Workgroup Conference Call
Meeting Minutes

Decisions/Discussion

1. Update on the progress of selecting an implementation alternative for the insurance match. Roy Nix and Sherri Grigsby traveled to Rhode Island and met with Sharon Santilli and George French to discuss the proposed CSLN role in implementing an effective matching program.
2. Discussion regarding data retention to identify duplicate matches and updates to previously provided matches. A question was posed to States on how long OCSE should retain original match information. The consensus was for OCSE to keep match information for six months, unless there is an update to the record, at which time the six month retention period starts over.
3. A suggestion was made to send unfiltered matched claims data (duplicates included) to States and the State would determine whether it is a duplicate record or a change to a previously provided record. Currently, New York filters duplicate insurance matches received from ISO. Some States may want unfiltered insurance match data and others may want OCSE to remove duplicates and provide an update indicator. Another suggestion was for OCSE to provide States with the option to receive filtered or unfiltered data.
4. For the OCSE insurance match initiative, an "exact duplicate" was defined as "no changes to all fields discussed." (May want to list fields here or indicate only the one's that the states didn't care about.)
5. Address Scrubbing: States agreed that OCSE would scrub all addresses associated with the match prior to returning the data to State CSE agencies.
6. Minimum amount of information States need to act on an insurance match:
• Insurance Company Name
• Insurance Company Address
• Insurance Company Contact Information
• Claim Type
• Claim Number (Note: Pennsylvania would like the match returned if there is no Claim Number associated with the record

ISO has mandatory fields that are required from insurance companies, and if they are not received, the claim is rejected. Since ISO will not be the only trading partner in this insurance match, different record layouts will be used and OCSE must identify the elements required by States to take action to intercept an insurance claim.

ISO does not currently pass back the claimant's employer information to CSLN. Since many State WC agencies will provide this information in their record layout, States identified this as data to flag if an update or change occurred to the previously provided match.

7. States requested OCSE provide a SSN verification indicator on the Insurance Match Response Record to identify verified SSNs.
8. Consensus was that States would receive initial insurance match record and would want any updates to the previously provided match records excluding changes to:
• Claimant Occupation
• Claimant Gender Code
• Claimant Professional License Number

Action Items

1. Inquire to Federal Management about cases with FV Indicator not going back to States.