eClaims Inquiry is a web application which provides the ability for Trading Partners (Senders), Vendors, Insurers and Third-Party Administrators (TPAs) to view both accepted and rejected claim transactions submitted to the Board. eClaims Inquiry also allows Insurers, Self-Insured Employers, Municipalities and TPAs the ability to view their payor compliance reports, along with requesting review of any penalties associated with these reports.
Effective 9/20/2019, eClaims Inquiry has been expanded to include the ability for Flat File (FTP) Trading Partners (Senders) to view their FTP acceptance rate performance to determine if they are meeting the 90% acceptance rate target as stated in the eClaims Implementation Guide Part 3.9. The expansion includes the following reports:
FTP Acceptance Chart
This chart displays the target percentage of 90% and the actual FTP acceptance percentage per month. It also includes the number of transactions submitted, rejected and accepted in that month.
Transaction Errors by Rejection Reasons
This report includes rejections that returned listing error type along with the error message received for each field that was rejected each month. It includes two FROI/SROI examples that can be viewed in the eClaims Inquiry FROI/SROI transaction search application to develop a corrective action plan to improve coding of edits.
Transaction Errors by Claim Administrator Claim Number
This report is sorted by the Claim Administrator Claim number that returned the rejection in the month. It also includes the error message returned to assist in reviewing the error in the Claim Administrator’s system to develop a corrective action plan to improve coding of edits.
Register for eClaims Inquiry
To request access to eClaims Inquiry, Trading Partners and Vendor administrators should register using the eClaims Administrator web application.
Insurers and Third-Party Administrators who are NOT Trading Partners should use the registration form found on the Register for eClaims Inquiry page. You will be required to designate an Administrator who will use the eClaims Administrator online web application to request or remove access for employees who will be using eClaims Inquiry to view submitted transactions.
Using eClaims Inquiry
- Enter your Search Criteria by selecting the Insurer ID or Claim Admin ID (or a combination of both) for the transactions you are interested in viewing.
- Enter your search criteria to narrow down the search results. You may search by:
- Jurisdiction Claim Number
- Claim Admin Claim Number
- Employee ID
- Employer FEIN
OR you can search for a specific FROI/SROI number
- Search Results provides the status and type of transaction and a summary identifying the employee, employer, insurer, claim administrator, sender and vendor. Accepted transactions will have a PDF icon which a user can select to view the transaction report.
- Transaction Detail allows the user to see specific portions of a transaction.
Questions can be directed to: eClaimsTradingPartner@wcb.ny.gov