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TITLE 50: INSURANCE
CHAPTER I: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION SUBCHAPTER l: PROVISIONS APPLICABLE TO ALL COMPANIES PART 928 MEDICAL MALPRACTICE DATA BASE SECTION 928.EXHIBIT D ILLINOIS MEDICAL PROFESSIONAL LIABILITY INSURANCE UNIFORM CLAIMS REPORTING (IMPLIUCR) BATCH REPORTING REQUIREMENTS AND NAVIGATIONAL USER'S GUIDE Section 928.EXHIBIT D Illinois Medical Professional Liability Insurance Uniform Claims Reporting (IMPLIUCR) – Batch Reporting Requirements and Navigational User's Guide
State of Illinois Department of Financial and Professional Regulation Division of Insurance
May 2006
Illinois Medical Professional Liability Insurance Uniform Claims Reporting (IMPLIUCR) Batch Requirements and Navigational User's Guide
To assist insurers and other reporting entities with electronic reporting, the Illinois Department of Financial and Professional Regulation-Division of Insurance (DOI) has created an electronic reporting application, which will be provided free of charge. Reporting entities will choose one of the two processes depending on how they prefer to file. One process will allow for data entry claim reporting and contain drop downs with choices. The other process will allow for batch reporting. This is the navigational user's guide for batch reporting.
General Submission Guidelines
1) Data Collection Information
a) Data must be submitted on 3˝" size diskette or compact disk (CD-R/RW).
b) Disks must conform to the filing specifications contained within this document.
2) Guidelines for Data Collection
a) Submission of data files must meet the filing specifications prescribed in this document.
b) DOI has created an electronic reporting application to help reporting entities enter and edit data and to create the quarterly claims report data file.
To access the on-line user guides for the electronic reporting applications, you must download Adobe Acrobat Reader software from URL: http://www.adobe.com/products/acrobat/main.html to access the on-line user guides.
c) If you have not received a copy of the electronic reporting application, you can download the software from the following URL: http://www.ins.state.il.us/exe/IMPLIUCRzip.exe
3) Data Format Standards To simplify aspects of the data collection process for the DOI, data and file formats for diskettes will consist of a delimited common ASCII representation.
4) File Description and Reporting Requirements (edit program process).
DOI has adopted the following specifications to be used in formatting the claims report data file information prior to using the "edit program".
Tab or Comma delimited file:
· File one report for each defendant you insure. · Include claims closed without payment. · When an item calls for a dollar amount and no amount is involved, enter 0 in the space. · Record all amounts in whole dollars. · All dates shall be in the format MM/DD/YYYY and have leading zeroes. Example: 01/01/2001 = January 1, 2001 · All names of individuals shall follow the following format: Last Name Suffix, First Name MI. (e.g., Public Jr, John Q.) · Insured Individual's name format: Last Name Suffix, First Name MI. Professional Designation (e.g., Public Jr, John Q. MD) · All fields for a given record, including fields that contain no data, shall have a Tab or Comma with a "full quote" text qualifier separator. There are a total of 75 fields that must be accounted for in each record (report).
General Submission Guidelines
Each of the following fields must have a Tab or Comma separator:
* If claim re-opened and a new Claim ID was assigned.
Examples using fields 1, 2, 3, 4, 5, 6, 7, 8
Example Tab delimited file: InsurerName[tab]12-1234567[tab]220BBA[tab]1[tab]01/09/2001[tab]01/09/2001[tab]01/09/2001[tab]01/09/2001[tab] etc …
Example Comma delimited (with a "full quote" text qualifier) file: "InsurerName","12-1234567","220BBA","1","01/09/2001","01/09/2001","01/09/2001","01/09/2001" etc …
5) Disk types
Disks submitted to the DOI shall be the 3˝" size or Compact Disk (CD-R/RW) from an IBM Personal computer or compatible. Disks will not be returned.
6) Computer Disk File Structures and Naming Conventions
Each disk submitted shall contain a physical file for Uniform Claims Reports.
A disk file name will be made up of two portions, a data name and an extension. The extension name will always be "txt". The file name of each file on the diskette will be:
DOI-IMPLIUCR and the Quarter and year being filed
Example with additional information: DOI-IMPLIUCR-1stQtr2004.txt
NOTE: The submission file on the disk will be created for you by the IMPLIUCR.MDE application.
7) TO BEGIN: Load the application (see installation instructions). Then import the claims data file Open/ClosedClaimsData.txt) you created. Use the "Validate Batch File of IMPLI Uniform Claims Reports" button on the IMPLIUCR application's main menu to import and validate your data.
Quarterly Claim Report Submission – Data Field Names and Report Format
For Field/Data Definitions and Requirements see Exhibit B of this Part.
Company FEIN and Claim ID (Key Fields) are combined to make a unique claim report. RI = Reporting Instructions numbering system reference.
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