Claims data provision guide for new applicants
ReturnToWorkSA collects claims data from self-insured employers under Schedule 3 of the Return to Work Regulations 2015. The type and format of the data to be provided is detailed within the Self-Insured employer EDI (Electronic Data Interchange) technical specification (DOCX, 832 KB).
An applicant for registration as a self-insured employer will need to:
- have in place a claims management database that is capable of transmitting claims data in the required format
- be granted access to the ReturnToWorkSA's secure online services - new users will need to register for an account
- undertake testing of its claims management database.
Below is a list of some software vendors that currently provide claims management systems to self-insured employers:
Once testing has been completed, the self-insured employer can start transmitting live data files. Live data transmissions must start within three months of registration as a self-insured employer.
A self-insured employer must ensure:
- data is transmitted every calendar month or such other time required by ReturnToWorkSA
- no more than two missed or failed/rejected data transmissions occur in any six-month period
- there are no occurrences of two or more consecutive missed or failed/rejected transmissions
- all errors at batch and line levels are resolved within one month of the error occurring
Self-insured employers must maintain procedures that describe their process for recording and transmitting data. Further information on self-insured data requirements can be located in the:
- Return to Work Regulations 2015
- Code of conduct for self-insured employers (PDF, 7971 KB)
- Self-Insured employer EDI Technical Specification (DOCX, 832 KB).
- EDI validations and error messages
If you require any further assistance on claims data, please email firstname.lastname@example.org or phone Kit Mitchell, Insurer Performance Analyst, on (08) 8233 2467.