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ICMS Overview

(INTEGRATED CLAIMS MANAGEMENT SYSTEM)

Our Goal of the ICMS System is to increase the responsiveness and effectiveness of SBWC staff by shifting the focus of their efforts from processing paper to providing customer service.

ICMS is being implemented in four phases.

Phase 1

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Development of the claims processing database

Phase 2

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Trial Management

Phase 3

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Web-based submission of forms

 

 

Managed Care processing

Phase 4

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EDI

Things To Know About ICMS
ICMS Phase 1 went into production October 1, 2005.  The first phase concentrates on the creation and processing of new claims. The new automated system allows for paper coming into SBWC to be scanned into an electronic folder.

  • Unique Claim Number
    ICMS creates a unique 10-digit number for each claim and attaches the number to information that comes to the Board about that claim. (The first 4 digits of the number represent the file date year.) All SBWC forms have been revised to include this unique claim. All correspondence with the Board must reference this number. For claims filed before October 1, 2005 a claim number has been created using the 10-digit format. SBWC will identify this number on out-going correspondence.
  • SBWC ID Number
    Insurers, Self-Insurers, and Group Funds have a number that identifies their particular organization. This organization number is required for certain forms.

Don't know your number?     SBWC ID#

Information for Attorneys

Attorneys of Record in a claim who provide an email address will be able to receive immediate electronic notifications of any document filed in a particular claim. *Email notifications should be activated by the end of October.

In order to communicate more effectively, the Board is asking attorneys to send the following information to ICMSprep@sbwc.ga.gov :

  • Attorney's Name
  • Attorney Primary Email address
  • Alternate Email address (up to 3 alternates)
  • Phone Number
  • Georgia Bar Number

 

Phase 1  (Fall 2005)

  • New mail procedures begin.
  • All new mail goes to document prep and scanning
  • Open and Active files are prepped and scanned as needed
  • Open but not active files are prepped and scanned as time allows
  • FAX documents can be received directly into the ICMS system
  • Key data is entered into ICMS for basic processing of a new claim
  • Workflow procedures support the creation of claim documents; includes the processing of WC-1, WC-14, WC-2, WC-4 and ancillary documents associated with claims
  • ICMS workflow includes benefit calculation, settlements, lump-sum advance payments and coverage verification.
  • Supplemental data is entered for Claims Processing, Licensure & QA, Settlements

 

Phase 2 (Summer 2006)

  • Complete workflow processing now exists for Hearings, ADR, and Appeals. Workflow includes case assignment, scheduling/docketing, conducting hearings & conferences; generation of orders; notification to parties.
  • Additional data is entered for Hearings, ADR, and Appeals
  • Based on workflow, system will generate documents such as notice of hearings, resolution of matters, or transmittal of orders for Hearings, ADR, and Appeals
  • Managed Care and I&R continue to enter data into mainframe GO system.

 

Phase 3 (Fall 2007)

  • Managed Care and Info & Referral workflow is now included in ICMS. SBWC can receive and send electronic rehabilitation plans, issue and sign administrative decisions, and collect performance feedback on rehabilitation suppliers.
  • Workflow generates documents for all divisions
  • Documents related to claims can now be submitted over the Internet.  Attorneys, claimants, insurers, self-insurers, TPA, physicians, rehabilitation suppliers can submit documents to SBWC over the Web.

 

Phase 4 (Fall 2007)

  • First Reports of Injury (WC-1 and WC-14s) and Subsequent Reports can be submitted via Electronic Data Interchange (EDI) format
  • External interfaces for full web-submission of documents completed
  • Data warehousing and ad-hoc reporting is finalized
  • All data from GO is migrated to ICMS

CONTINUE TO CHECK THIS SITE FOR ICMS NEWS UPDATES.