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Did you know that invalid or missing policy information may cause states to reject Proof of Coverage (POC) data?
Let’s look at three Policy data elements that cause state rejections on your IAIABC POC Coverage Provider Reject and Error Report.
Federal Employer Identification Number (FEIN)
Many states reject POC transactions when the reported FEIN does not match what is on file for the insured
in the state’s database.
To resolve these rejects, contact your insured or the state to validate the FEIN and correct the Policy data as needed. NCCI’s POC State Guide contains POC contact information for each state.
State Unemployment Identification Number (UI Number)
States issue UI Numbers to employers for the purpose of collecting unemployment taxes. Currently,
Hawaii, Maine, and Rhode Island require this number on employer name records linked to their state.
To resolve a rejected number, replace it with a valid number. NCCI’s POC State Guide indicates when
default codes may be reported and provides state contact information for obtaining valid UI Numbers.
Industry Code (NAICS Code)
NAICS codes are used by state and federal governments to indicate the type of business an insured
is conducting. NCCI’s POC State Guide indicates the states that require an NAICS code to be reported in
the Industry Code field for address records in the state.
These errors are resolved by adding a valid NAICS code or replacing a rejected number. Valid NAICS codes can be found at: https://www.census.gov/eos/www/naics.
Based on stakeholder feedback, a new optional process is now available for carriers and group level access
providers to make Key Field Changes to previously reported Medical Data Call records. This flexible alternative
does not change the current reporting requirements, but rather provides an option to ease the process for making
Key Field Changes. To determine whether this claim-level alternative could be utilized, NCCI recommends that data
reporters review how they currently supply the Medical Data Call with Key Field Changes.
For additional details, please see the Resources for the Medical Data Call article.
In September, NCCI added seven more validation edits. Details may be found in the Unit Statistical Edit/Validation
Matrix. Along with the new edits, NCCI refined and improved the display of validation edits in the Unit Data Collection (UDC) tool.
New Validation Tab
NCCI has added a Validation tab to the Unit Details current view.
This tab displays data such as aggregate exposure, premium, and claim counts that is not displayed elsewhere on the
unit. The tab is specific to new edits C811, C821, and E992. You can access the tab from the Unit Details—Current
View or by clicking on the Details option on Validation Search.
The new tab includes an Export Results feature that allows you to download the data on the tab to an Excel
Additional Fields on Exports and Reports
The new Validation tab export and the existing Validation Search export and reports displays two new fields:
- Matching Number—Identifies rows that are grouped together due to related conditions
- Insured Name—Shows the name associated with the unit
These additions will facilitate your research when using the exports and reports.
Condition Status Updates
Pending is now Pending at NCCI. This clarifies that a correction, subsequent report, or a detailed explanation is being evaluated by NCCI validators. The data provider does not need to take any further action while an edit is in this status.
For additional information, refer to Circular DQ-2020-02.