REGULATORY REPORTING

The Largest & Most Trusted EDI Partner in the P&C Industry

With 39 states that require regulatory reporting—and make changes to their regulations at least once per year—it’s crucial that your claims organization has a comprehensive Electronic Data Interchange (EDI) solution in place to remain compliant with the ever-changing state reporting requirements. Enlyte Regulatory Reporting Solutions support both First Report of Injury and Subsequent Report of Injury reporting and Centers for Medicare & Medicaid Services (CMS) reporting via more than 15,000 mandatory, conditional and sequencing edits, allowing for excellent data quality and operational efficiency. Our solutions are deeply integrated with Enlyte's bill review platform and are customizable to your specific business needs, helping to take the pain out of the regulatory reporting process.

FROI/SROI REPORTING

First Report of Injury & Subsequent Report of Injury

Our FROI/SROI reporting ensures that customers stay compliant with workers’ comp regulations and policies.

CMS REPORTING

Centers for Medicare & Medicaid Services

Submit queries and reports pursuant to Section 111 CMS reporting requirements, including automatic resubmission, where required.

AVAILABLE MODULESStandard Modules

Learn more about our premium, standard and basic options, as well as our optional modules below:

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Auto Triggers (Premium Model)

Creates efficiency through automation

Reduces the manual work involved with EDI compliance processes

Automatically exports your raw claims data and can take care of the rest

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Import/Export (Standard Model)

Eliminates manual data entry by exporting FROI/SROI data from your claims management system

Submits files for all IAIABC releases in a single file format

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Data Entry (Basic Model)

Assembles, manages and submits the required information in compliance with jurisdictional regulations in our easy-to-use, secure web portal

AVAILABLE MODULESOptional Modules

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WCIRB Indemnity Reporting

We leverage your FROI/SROI records and report them to the Workers’ Compensation Insurance Rating Bureau (WCIRB), so you don’t have to!

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Sequencing*

We can manage the sequencing process for you, helping eliminate headaches and boosting efficiency.

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Change Reporting – 3.1 Standard*

The IAIABC Claims Release 3.1 Standard requires claims organizations to report out on any data elements that are changed. Enlyte can automatically identify the changes in any 02 transaction to handle this process for you.

BENEFITS

Benefits of Using Enlyte Regulatory Reporting Solutions

Leverage Enlyte's deeply integrated and automated regulatory reporting software, and we’ll be your single connection to help you handle your state reporting, remain compliant and achieve operational efficiency.

  • An award-winning team of dedicated EDI experts with direct experience working with the International Association of Industrial Accident Board and Commissions (IAIABC)
  • 15,000+ mandatory and conditional edits
  • The tools to handle regulatory reporting for you, so you can focus on your core capabilities
  • Automated workflows to help boost efficiency and compliance with regulations
  • Complete management of all changes from the 39 states that require regulatory reporting
  • Customizable solutions that fit the needs of your organization
  • Detailed reporting accuracy, efficiency and tracking
  • Precise communication, error monitoring and correcting

Find Out More

Combine industry-leading technology with deep market expertise to achieve exceptional claim outcomes. Schedule a consultation to learn more about our comprehensive suite of integrated casualty services and solutions.