WCB 1600 Byte Electronic Forms

2001.12.17

Overview

Since April, 2001, MedOffIS has supported the WCB "1600 byte" form 8 and form 11 which can be electronically submitted to WCB via Teleplan. Overall, users find this method of submitting physician reports to WCB to be superior to the old way of writing out the forms and faxing them. Experience by numerous sites over several months is that payment is faster and nearly always forthcoming. The physiotherapy "1200 byte" E-form for electronic submission via Teleplan is nearly complete and is being tested in one clinic.

The following outline is helpful in understanding the WCB electronic reporting process:

1967 - Medical Services Act created Overall Medical Services Plan

1974 - OMSP changed to MSP. One year later, CU&C, BCMP, and MSA amalgamated into MSP

1985 - MSP piloted a system called Teleplan to electronically submit MSP claims.

May 1987 - an improved Teleplan II went into production to process claims, payments, refusals and remittances. Software called SIMPC to enable modem transfer of ASCII text data was provided to practitioners at no cost. Toll free lines around the province also supplied

April 1989 - becomes mandatory to submit claims to MSP electronically. Can submit claims by cards if billing less than $72,000 per year but charge of about $0.40 for each card submitted.

April 1994 - Implementation of a flag for MVA related medical visits.

May 1996 - Billing claims to WCB via Teleplan enabled.

October 1996 - Billing form fees to WCB via Teleplan enabled.

April 1997 - WCB "400 byte" electronic reporting specifications. Uses the 400 byte note record that can be sent to MSP for each claim record. Only one vendor in B.C. (Osler) incorporates this in their software.

December 1998 - WCB "1200 byte" electronic reporting specifications. Uses 3 consecutive claim records each with a note record to create F8 and F11 WCB reports. No vendors use this specfication. Each form has alot of fields data which still are quite short making it difficult to transcribe the usual progress notes and truncation of data would be common.

April, 2001 - WCB "1600 byte" electronic reporting specifications. Uses 4 consecutive claim records each with a note record to create a single report (F8 and F11 information included on one form with two byte specifier to indicate which type of form is being submitted).

Advantages

Electronic reporting has the following advantages over submitting paper forms:

1. Reports readable to all parties.
2. Reports and billing information travel together. This should decrease the dreaded "Report not found" error which delays payment of claims.
3. Reports do not have to be faxed. They can travel in the same process that submits claims to MSP, ICBC and WCB. Teleplan is already in place in most physician offices. Access to the internet is not required.
4. The new form has a block of text area for clinical information which can take up to 800 bytes (characters) of information. If progress notes are currently typed either in word processing document for pasting into chart or in electronic medical record, the already typed information can be copied to the clipboard and pasted into the WCB form.
5. If progress notes are not currently typed, there is now another reason to dictate more and save time. Very few physicians currently write referral letters or other correspondance with pen and paper. It is more efficient to dictate, use voice recognition or type if one has modest typing skills.
6. Information that does not change such as demographic information, employer name and address, date of injury, CSA codes etc can be autofilled to the form. This information has to be added manually on every visit if paper forms are used.

The new reporting format, either paper or electronic has the following advantages over the old forms:

1. Only one form is required for first report (F8) and subsequent reports (F11). One therefore only has to become familiar with one format which accomodates the needs of both situations. Sometimes the features of a first report are useful in followup. For example, one often becomes aware of significant past problems which were not apparent on first visit.
2. Larger area for clinical information to accomodate the usual progress notes used for most visits
3. Return to work issues simplified with a text box to indicate physical and/or psychological restrictions. It is not expected that the physician comment on "modified" or "light" duties, gradual return to work etc. Simply listing the restrictions can then be used by the case manager, employer and if necessary, medical or nurse advisor, to make return to work plans. This avoids the physician being put in the position of making RTW recommendations without full knowledge of the workplace.
4. Return to work in any capacity estimate is important. Generally, workers recover faster and more completely if they maintain an attachment to the workplace.
5. Estimate of time at which Maximal Medical Recovery (otherwise known as Maximal Medical Improvement) is expected to occur is also important. This is meant to keep all parties aware of reasonable expectations for recovery. This is very helpful for planning return to work and if necessary, vocational rehabilitation.

The new electronic format has the following advantages over the old electronic formats:

1. More space for clinical information.
2. Amalgamating clinical information into one text block reduces chance of truncated data and maximizes efficiency of sending notes in a limited space. When details in one aspect of the visit are important, unused area for other aspects can be used.
3. Only one database table is needed for first (F8) and subsequent (F11) reports. The physician office software needs only to provide one screen, or series of screens, to enter the data (ie only one place to go instead of two). This also simplifies the process of converting the reports to formatted text data which is sent via Teleplan.
4. Less coding - the 1200 byte specifications included 3 sets of CSA codes (each set comprised of area of injury, body part and nature of injury). The new specifications call for only one set.

The picture of the new form shown below shows mandatory fields in blue, fields that can be mandatory depending on previous response in green and non-mandatory fields in black:

<1600 Byte Form Mandatory Fields>

Table of data element details:

Medical Office Information Systems