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Documents placed in this folder are to be considered in draft form until approved by the Maine Workers' Compensation Board of Directors. As each document is developed it will be placed here in an effort to share the information. Please email paul.fortier@maine.gov or phone 207-287-3818 with any comments or questions. Thank you for your patience and assistance. Tables below are either Acrobat 6.0, Microsoft Word or Microsoft Excel format.

Implementation Guides - The Maine WCB Claims Implementation Guide is provided to assist Claim Administrators, Insurers and Self Insures with Maine specific information regarding Electronic Data Reporting to the State of Maine Workers Compensation Board. The IAIABC Claims R3 Implementation Guide provides detailed information regarding system information, code tables, scenarios, data elements, etc.

Event Table - claim events for reporting FROI and SROI Denials to the Maine Workers' Compensation Board. Maintenance Type Codes for events and circumstances under which a FROI and SROI Denials should be sent.

Element Requirement Table - list of data elements that are required for submission of a FROI and SROI Denials.

Edit Matrix Table - applied editing based on the IAIABC standards and Maine's FROI and SROI Denial data requirements; SROI Payment requirements will be presented as a later date.

Denial Schedule/Testing Requirements - the testing schedule and minimum batch requirements for Phase II Me WCB EDI implementation.

List of Errors - The list of errors contains WCB and IAIABC error numbers and descriptions.

WCB 9 Notice of Controversy form - the WCB-9 Notice of Controversy form has been modified to reflect changes to some data elements and to add a some additional date fields. A crosswalk of the NOC form is provided to assist in identifying the DN elements associated with each box. When printing the Full Denial and Partial Denial Reason Codes please add the corresponding text, see example 1 and example 2.

Electronic Claims Online Services

Documents on this page may be provided in PDF, Microsoft Word or Excel formats. To view PDF documents, you will need the free Adobe Reader. To view MS Word documents, you will need Microsoft Word or the free Word Viewer. To view MS Excel documents, you will need Microsoft Excel or the free Excel Viewer. If you need assistance, view our PDF Help page or contact us at paul.fortier@maine.gov or (207)287-3818.