J.2 Appendix B - WCCCSUserGuide v6.3.pdf

Workers’ Compensation Case Control System (WCCCS)

User Guide

Version 6.3

Rev. 2022/10 January COBR-Q1-2022-v6.3

WCCCS User Guide Confidentiality Statement ii

Confidentiality Statement

The collection of this information is authorized by Section 1862(b) of the Social Security Act (codified at 42 U.S.C 1395y(b)) (see also 42, C.F.R. 411.24). The information collected will be used to identify and recover past conditional and mistaken Medicare primary payments and to prevent Medicare from making mistaken payments in the future for those Medicare Secondary Payer situations that continue to exist. The Privacy Act (5 U.S.C. 552a(b)), as amended, prohibits the disclosure of information maintained by the Centers for Medicare & Medicaid Services (CMS) in a system of records to third parties, unless the beneficiary provides a written request or explicit written consent/authorization for a party to receive such information. Where the beneficiary provides written consent/proof of representation, CMS will permit authorized parties to access requisite information.

WCCCS User Guide Table of Contents iii

Table of Contents CHAPTER 1 : SUMMARY OF VERSION 6.3 UPDATES ................................................................1-1 CHAPTER 2 : INTRODUCTION.....................................................................................................2-1

2.1 What is WCCCS? ..................................................................................................................2-1

2.2 WCCCS Workflow .................................................................................................................2-1

2.2.1 BCRC Processing ......................................................................................................2-2

2.2.2 WCRC Processing .....................................................................................................2-3

2.2.3 RO Processing ...........................................................................................................2-3

2.2.4 Streamline Approval Process......................................................................................2-4

2.3 System Interfaces..................................................................................................................2-5

2.4 System Configuration ............................................................................................................2-6

2.4.1 Minimum Configuration...............................................................................................2-6

2.4.2 Java Settings ................................................................. Error! Bookmark not defined.

2.5 Authority................................................................................................................................2-6 CHAPTER 3 : BASIC USER AND ADMINISTRATOR TASKS .......................................................3-1

3.1 Logging into WCCCS ............................................................................................................3-1

3.2 Changing Your Password at First Sign In and Every 60 Days .................................................3-2

3.3 Transportation Links ..............................................................................................................3-3

3.4 Basic User Tasks ..................................................................................................................3-4

3.4.1 Viewing Your Group Information .................................................................................3-5

3.4.2 Viewing Your User Profile...........................................................................................3-6

3.4.3 Changing Your Password from the User Information Screen .......................................3-7

3.5 Basic Administrative Tasks ....................................................................................................3-7

3.5.1 Password Requirements ............................................................................................3-7

3.5.2 Requesting Reports ...................................................................................................3-7

CHAPTER 4 : ADMINISTRATOR-SPECIFIC TASKS.....................................................................4-1

4.1 Updating Group Information...................................................................................................4-2

4.2 Adding a New User................................................................................................................4-3

4.3 Viewing the User List Screen .................................................................................................4-5

4.4 Updating a User’s Information................................................................................................4-5

4.5 Resetting a User’s Password at the Same Location................................................................4-6

4.6 Resetting a User’s Password at Another Location ..................................................................4-6

4.7 Case Locking Maintenance....................................................................................................4-7 CHAPTER 5 : BCRC IMAGING AND INITIAL DATA ENTRY.........................................................5-1

5.1 BCRC Image Screens ...........................................................................................................5-1

5.1.1 Work List Screen........................................................................................................5-1

5.1.2 Displaying Images in the WCCCS Image Viewer.........................................................5-2

5.1.3 Image Search Screen.................................................................................................5-3

5.2 BCRC Data Entry Screens.....................................................................................................5-6

5.2.1 BCRC Data Entry Screen ...........................................................................................5-7

5.2.2 Beneficiary Information...............................................................................................5-9

5.2.3 Entitlement Information.............................................................................................5-10 iv

5.2.4 Diagnosis Information...............................................................................................5-11

5.2.5 Administrator Information Screen..............................................................................5-12

5.2.6 Claimant Attorney Information Screen.......................................................................5-13

5.2.7 Employer Information Screen ...................................................................................5-14

5.2.8 Submitter Information Screen ...................................................................................5-15

5.2.9 WC Carrier Screen ...................................................................................................5-15

5.2.10 Rep. Payee Information Screen ................................................................................5-16

5.2.11 Note Log ..................................................................................................................5-17

5.2.12 Settlement Detail Screen ..........................................................................................5-18

5.3 Streamline Approval Process ...............................................................................................5-24 CHAPTER 6 : WCRC AND RO WORKFLOW ................................................................................6-1

6.1 The Submit Button.................................................................................................................6-1

6.2 Case List Screen ...................................................................................................................6-2

6.2.1 Searching for Cases...................................................................................................6-6

6.2.2 Sorting the Case List ..................................................................................................6-6

6.2.3 Examining a Case ......................................................................................................6-6

6.2.4 Exiting the Case List Screen.......................................................................................6-6

6.3 Case Information Screen and Case Buttons ...........................................................................6-6

6.3.1 Creating a New Non-Submission Case .......................................................................6-9

6.3.2 Changing an Existing Case Type to Non-Submission ................................................6-10

6.3.3 Commingling Screens and Process ..........................................................................6-10

6.4 Beneficiary Information Screen ............................................................................................6-12

6.4.1 Diagnosis Code Lookup Dialog.................................................................................6-15

6.5 Contacts..............................................................................................................................6-16

6.5.1 Administrator Information Screen..............................................................................6-16

6.5.2 Claimant Attorney Information Screen.......................................................................6-17

6.5.3 Employer Information Screen ...................................................................................6-18

6.5.4 Submitter Information Screen ...................................................................................6-19

6.5.5 WC Carrier Screen ...................................................................................................6-20

6.5.6 Rep. Payee Information Screen ................................................................................6-21

6.6 History Screen.....................................................................................................................6-21

6.7 Note Log .............................................................................................................................6-22

6.8 Settlement Detail Screen .....................................................................................................6-24

6.9 Recommendations ..............................................................................................................6-29

6.9.1 Treatment Status and Unrelated Treatment Screens .................................................6-30

6.9.2 Future Treatment Screen .........................................................................................6-32

6.9.3 Pharmacy Screen.....................................................................................................6-36

6.9.4 Decision Rationale Screen .......................................................................................6-46

6.10 Approval Letter History Screen ............................................................................................6-48

6.11 Closeout Letter History Screen ............................................................................................6-50

6.12 Development Letter History Screen......................................................................................6-51

6.13 Development Letter Information Screen ...............................................................................6-52

6.14 Recommendation Letter History Screen ...............................................................................6-54

6.15 Re-Review Request History Screen .....................................................................................6-55 v

6.15.1 Re-Review Request Screen .....................................................................................6-57

6.16 Letter Archive Screen ..........................................................................................................6-59

6.17 Historical Rx Lookup Screen ................................................................................................6-61

6.18 Required Resubmission.......................................................................................................6-63

6.19 Re-Review or Amended Re-Review Requests .....................................................................6-64

6.19.1 Regional Office Creation of a Re-Review or Amended Re-Review Request ...............6-68

6.19.2 WCRC Processing of a Re-Review or Amended Re-Review Request........................6-70

6.19.3 RO Processing of a Re-Review or Amended Re-Review Request Response from the

WCRC .....................................................................................................................6-71

6.19.4 Viewing Completed Re-Review or Amended Re-Review Requests for a Case ...........6-73

APPENDIX A : SYSTEM FLOWCHART ....................................................................................... A-1 APPENDIX B : REPORTS ............................................................................................................ B-1 WCCCS Production Report ........................................................................................................... B-4 WCRC Report............................................................................................................................... B-5 WCCCS Quality Assurance Report................................................................................................ B-7 WCCCS Inventory Report ............................................................................................................. B-8 WCCCS Monthly Aged Report ...................................................................................................... B-9 WCRC Nightly Reports ............................................................................................................... B-10 WCMSA Caseload Report........................................................................................................... B-16 WCMSA Status Report for Processed Cases............................................................................... B-18 WCMSA Status Report for Pending Cases .................................................................................. B-20 WCMSA Summary Report........................................................................................................... B-21 WCMSA Summary Status Report ................................................................................................ B-23 WCMSA Pending Report............................................................................................................. B-24 WCMSA Regional Office Pending DISP Case Inventory Report ................................................... B-26 WCMSA Regional Office Pending DREC Case Inventory Report ................................................. B-27 WCMSA Regional Office Pending RECD Case Inventory Report ................................................. B-28 WCMSA Regional Office Pending ASGN Case Inventory Report ................................................. B-29 WCMSA Summary Backlog Report ............................................................................................. B-30 WCMSA Structured Settlement MSP Report................................................................................ B-31 WCMSA Case Development Required Report ............................................................................. B-32 WCCCS Caseload Summary Report ........................................................................................... B-34 WCCCS Age Summary Report.................................................................................................... B-35 WCCCS Detailed Pending Report ............................................................................................... B-36 WCCCS Detailed Closed Report ................................................................................................. B-37 WCMSA Portal Workload Report ................................................................................................. B-38 WCMSA Portal Inappropriate Submission Report ........................................................................ B-39 WCMSA Portal Submitters with Commingled Document Report ................................................... B-40 WCMSA Portal Submitter Status List ........................................................................................... B-41 WCMSA Re-Review Request ...................................................................................................... B-42

APPENDIX C : DOCUMENT MANAGEMENT SYSTEM................................................................ C-1 Viewing Functions......................................................................................................................... C-3 Annotations (Internet Explorer Only) .............................................................................................. C-3 Adding Bookmarks ........................................................................................................................ C-6 vi

Changing Document Type............................................................................................................. C-7 Deleting Non-Submission Documents ........................................................................................... C-8 Initiating the Commingling Process................................................................................................ C-9 Reviewing for Commingled Documentation ................................................................................. C-10 Reviewing Supplemental Settlement/NGHP Documentation ........................................................ C-10

APPENDIX D : LETTERS ............................................................................................................. D-1 Mailing Schedule for WCCCS Letters ............................................................................................ D-1 APPENDIX E : FOREIGN ADDRESS LAYOUT ............................................................................ E-1 APPENDIX F : WCCCS ACTION VS. CWF AND MBD RECORDS ............................................... F-1

APPENDIX G : ACRONYMS ........................................................................................................ G-1 APPENDIX H : PREVIOUS VERSION UPDATES ......................................................................... H-1

List of Figures Figure 2-6: Configure Java Menu Option ............................................ Error! Bookmark not defined.

Figure 2-7: Java Control Panel, Security Tab ...................................... Error! Bookmark not defined.

Figure 2-8: Java Control Panel, Advanced Tab ................................... Error! Bookmark not defined.

Figure 3-1: WCCCS Login Screen ..................................................................................................3-1 Figure 3-2: Change Password Screen ............................................................................................3-2 Figure 3-3: Transportation Links .....................................................................................................3-3 Figure 3-4: Administration Menu Screen .........................................................................................3-4 Figure 3-5: Group Information Screen ............................................................................................3-5 Figure 3-6: User Information Screen ...............................................................................................3-6 Figure 3-7: Reports Menu ..............................................................................................................3-8 Figure 3-8: WCMSA Report Options ...............................................................................................3-8 Figure 3-9: WCMSAP Reports Options ...........................................................................................3-9 Figure 4-1: Administration Menu Screen for Administrators .............................................................4-1 Figure 4-2: Group Information Screen ............................................................................................4-2 Figure 4-3: Blank User Information Screen .....................................................................................4-3 Figure 4-4: User List Screen...........................................................................................................4-5 Figure 4-5: Reset Password ...........................................................................................................4-6 Figure 4-6: User List Screen...........................................................................................................4-7 Figure 4-7: Locked Cases Screen ..................................................................................................4-7 Figure 5-1: Work List Screen ..........................................................................................................5-2 Figure 5-2: WCCCS Image Viewer .................................................................................................5-3 Figure 5-3: Image Search Screen ...................................................................................................5-5 Figure 5-4: BCRC Data Entry Screen Buttons.................................................................................5-6 Figure 5-5: BCRC Data Entry Screen .............................................................................................5-8 Figure 5-6: “Beneficiary Deceased” Alert ........................................................................................5-9 Figure 5-7: Entitlement Information Section ..................................................................................5-10 Figure 5-8: Diagnosis Information Section ....................................................................................5-11 Figure 5-9: Administrator Information Screen ................................................................................5-12 Figure 5-10: Claimant Attorney Information Screen .......................................................................5-13 Figure 5-11: Employer Information Screen....................................................................................5-14 Figure 5-12: Submitter Information Screen ...................................................................................5-15 vii

Figure 5-13: WC Carrier Screen ...................................................................................................5-16 Figure 5-14: Rep. Payee Information Screen ................................................................................5-17 Figure 5-15: Note Log ..................................................................................................................5-17 Figure 5-16: Note Log Details Dialog Box .....................................................................................5-18 Figure 5-17: Settlement Detail Screen ..........................................................................................5-19 Figure 5-18: “Recommendation Letter Needed” Alert .......................... Error! Bookmark not defined.

Figure 5-19: Payout Schedule Override Check Box ......................................................................5-23 Figure 5-20: Payout Schedule Edit Section ...................................................................................5-24 Figure 5-21: Case List Screen (RO99)..........................................................................................5-25 Figure 5-22: Remove Case from Streamline Approval Process .....................................................5-25 Figure 6-1: Case List Search Screen ..............................................................................................6-3 Figure 6-2: Case List Screen ..........................................................................................................6-4 Figure 6-3: Case Information Screen and Case Buttons..................................................................6-7 Figure 6-4: Upload Non-submission Documentation .....................................................................6-10 Figure 6-5: Commingled Letter/Alert History Screen .....................................................................6-11 Figure 6-6: Commingling Letter/Alert Information Screen ..............................................................6-11 Figure 6-7: Beneficiary Information Screen ...................................................................................6-13 Figure 6-8: Diagnosis Code Lookup Dialog ...................................................................................6-15 Figure 6-9: Administrator Information Screen ................................................................................6-16 Figure 6-10: Claimant Attorney Information...................................................................................6-18 Figure 6-11: Employer Information Screen....................................................................................6-18 Figure 6-12: Submitter Information Screen ...................................................................................6-19 Figure 6-13: WC Carrier Screen ...................................................................................................6-20 Figure 6-14: Rep. Payee Information Screen ................................................................................6-21 Figure 6-15: History Screen..........................................................................................................6-22 Figure 6-16: Note Log ..................................................................................................................6-23 Figure 6-17: Note Log Details Dialog ............................................................................................6-23 Figure 6-18: Settlement Detail Screen ..........................................................................................6-25 Figure 6-19: “Recommendation Letter Needed” Alert .......................... Error! Bookmark not defined.

Figure 6-20: Payout Schedule Override Check Box ......................................................................6-29 Figure 6-21: Payout Schedule Edit Section ...................................................................................6-29 Figure 6-22: Recommendations Menu ..........................................................................................6-30 Figure 6-23: Check Spelling Dialog...............................................................................................6-31 Figure 6-24: Treatment Status Screen ..........................................................................................6-31 Figure 6-25: Unrelated Treatment Screen .....................................................................................6-32 Figure 6-26: Future Treatment Screen..........................................................................................6-32 Figure 6-27: Major Medical Center Lookup (Example)...................................................................6-34 Figure 6-28: Future Treatment Details ..........................................................................................6-35 Figure 6-29: Delete Confirmation Window.....................................................................................6-35 Figure 6-30: Pharmacy Screen .....................................................................................................6-36 Figure 6-31: Existing Drug Redbook Details..................................................................................6-39 Figure 6-32: Rx Detail Screen ......................................................................................................6-39 Figure 6-33: Pricing Chart - Add/Edit ............................................................................................6-39 Figure 6-34: Pricing Chart - National Drug Code ...........................................................................6-40 Figure 6-35: Sample Pricing Chart Calculation..............................................................................6-40 viii

Figure 6-36: Pricing Chart - Grand Total .......................................................................................6-40 Figure 6-37: Pricing Chart - Drug Name........................................................................................6-40 Figure 6-38: Pricing Chart - Existing Drug Records .......................................................................6-41 Figure 6-39: Redbook Pricing Rx Search ......................................................................................6-41 Figure 6-40: Rx Search Screen ....................................................................................................6-44 Figure 6-41: Rx Search Results....................................................................................................6-44 Figure 6-42: Pricing Chart Showing an Rx Search Result..............................................................6-44 Figure 6-43: Pricing Chart – Existing Drug Records Section ..........................................................6-45 Figure 6-44: Pricing Chart – Add/Edit Section ...............................................................................6-45 Figure 6-45: Pricing Chart – Editing No. Years..............................................................................6-45 Figure 6-46: Pricing Chart - Recalculation of Grand Total..............................................................6-46 Figure 6-47: Deleting an Existing Drug .........................................................................................6-46 Figure 6-48: Delete Drug Confirmation .........................................................................................6-46 Figure 6-49: Decision Rationale Screen........................................................................................6-47 Figure 6-50: Approval Letter History Screen .................................................................................6-49 Figure 6-51: Closeout Letter History Screen .................................................................................6-50 Figure 6-52: Development Letter History Screen...........................................................................6-52 Figure 6-53: Development Letter Information Screen ....................................................................6-53 Figure 6-54: Recommendation Letter History Screen ....................................................................6-54 Figure 6-55: Re-Review Request History Screen ..........................................................................6-56 Figure 6-56: Re-Review Request Screen (Historical) ....................................................................6-58 Figure 6-57: Archives Button ........................................................................................................6-59 Figure 6-58: Archives Link............................................................................................................6-59 Figure 6-59: Letter Archive Screen (Search Availability) ................................................................6-59 Figure 6-60: Letter Archive Screen ...............................................................................................6-60 Figure 6-61: Rx Lookup Link ........................................................................................................6-61 Figure 6-62: Historical Rx Lookup Screen .....................................................................................6-61 Figure 6-63: Rx Lookup Screen ....................................................................................................6-62 Figure 6-64: Rx Detail Screen ......................................................................................................6-62 Figure 6-65: Rx Historical Detail Screen .......................................................................................6-63 Figure 6-66: Case Header with Enable Amended Review via WCMSAP Checkbox .......................6-64 Figure 6-67: Re-Review Request Form.........................................................................................6-66 Figure 6-68: Re-Review Button ....................................................................................................6-68 Figure 6-69: Pre-Populated Re-Review Request Form..................................................................6-68 Figure 6-70: Reason for Re-Review Options .................................................................................6-68 Figure 6-71: WCRC Response Requested Section .......................................................................6-68 Figure 6-72: Reason for Re-Review Request Section ...................................................................6-69 Figure 6-73: CMS Re-Review Response Section ..........................................................................6-69 Figure 6-74: Re-Review Request Response .................................................................................6-70 Figure 6-75: Number of Re-Review Requests Link........................................................................6-71 Figure 6-76: WCRC Re-Review Response Section .......................................................................6-71 Figure 6-77: CMS Re-Review Response Section ..........................................................................6-72 Figure 6-78: Letter Request Alert..................................................................................................6-72 Figure 6-79: Acknowledgement Letter History Screen ...................................................................6-73 Figure 6-80: Re-Review and Amended Request Response Letter History Screen..........................6-73 ix

Figure 6-81: Re-Review Request Dialog .......................................................................................6-74 Figure A-1: System Flowchart (1) .................................................................................................. A-2 Figure A-2: System Flowchart (2) .................................................................................................. A-3 Figure A-3: System Flowchart (3) .................................................................................................. A-4 Figure A-4: System Flowchart (4) .................................................................................................. A-5 Figure A-5: System Flowchart (5) .................................................................................................. A-6 Figure B-1: WCMSA Reports Main Menu Screen........................................................................... B-1 Figure B-2: WCMSAP Reports Menu............................................................................................. B-2 Figure B-3: Sample WCCCS Production Report ............................................................................ B-4 Figure B-4: Sample WCRC Report ................................................................................................ B-5 Figure B-5: Sample WCCCS Quality Assurance Report ................................................................. B-7 Figure B-6: Sample WCCCS Inventory Report............................................................................... B-8 Figure B-7: Sample WCCCS Monthly Aged Report ........................................................................ B-9 Figure B-8: WCRC Nightly Reports.............................................................................................. B-10 Figure B-9: Sample Case Count Report....................................................................................... B-10 Figure B-10: Sample Case Count by Assigned Operator Report................................................... B-11 Figure B-11: Sample Case Count by Status Report ..................................................................... B-12 Figure B-12: Sample BCRC Work List Counts Report .................................................................. B-13 Figure B-13: Sample Monthly Case Counts Report ...................................................................... B-13 Figure B-14: Sample User Case Counts by Status Report............................................................ B-14 Figure B-15: Sample WCMSA Caseload Report .......................................................................... B-16 Figure B-16: Sample WCMSA Status Report for Processed Cases .............................................. B-18 Figure B-17: Sample WCMSA Status Report for Pending Cases .................................................. B-20 Figure B-18: Sample WCMSA Summary Report .......................................................................... B-21 Figure B-19: Sample WCMSA Summary Status Report ............................................................... B-23 Figure B-20: Sample WCMSA Pending Report ............................................................................ B-24 Figure B-21: Sample WCMSA Regional Office Pending DISP Case Inventory Report................... B-26 Figure B-22: Sample WCMSA Regional Office Pending DREC Case Inventory Report ................. B-27 Figure B-23: Sample WCMSA Regional Office Pending RECD Case Inventory Report ................. B-28 Figure B-24: Sample WCMSA Regional Office Pending ASGN Case Inventory Report ................. B-29 Figure B-25: Sample WCMSA Summary Backlog Report ............................................................. B-30 Figure B-26: Sample WCMSA Structured Settlement MSP Report ............................................... B-31 Figure B-27: Sample WCMSA Case Development Required Report............................................. B-32 Figure B-28: Sample WCCCS Caseload Summary Report........................................................... B-34 Figure B-29: Sample Age Summary Report ................................................................................. B-35 Figure B-30: Sample WCCCS Detailed Pending Report ............................................................... B-36 Figure B-31: Sample WCCCS Detailed Closed Report................................................................. B-37 Figure B-32: Sample WCMSA Portal Workload Report ................................................................ B-38 Figure B-33: Sample WCMSA Portal Inappropriate Submission Report ........................................ B-39 Figure B-34: Sample WCMSA Portal Commingled Document Report ........................................... B-40 Figure B-35: Sample WCMSA Portal Submitter Status Report ..................................................... B-41 Figure B-36: Sample WCCCS Production Report ........................................................................ B-42 Figure C-1: Document Management System Main Screen ............................................................. C-1 Figure C-2: New Window Link ....................................................................................................... C-2 Figure C-3: New Window Image .................................................................................................... C-2 x

Figure C-4: Image Selection Error ................................................................................................. C-2 Figure C-5: Bookmark Dialog ........................................................................................................ C-6 Figure C-6: Bookmark Displayed ................................................................................................... C-7 Figure C-7: Change Type Dialog ................................................................................................... C-8 Figure C-8: Change Type List........................................................................................................ C-8 Figure C-9: Delete Non-Sub Document ......................................................................................... C-9 Figure C-10: Reviewing Commingled Documentation .................................................................. C-11

List of Tables Table 2-1: WCCCS Location and Status Code Descriptions ............................................................2-1 Table 3-1: WCCCS Login Screen Descriptions ...............................................................................3-1 Table 3-2: Change Password Screen Descriptions .........................................................................3-3 Table 3-3: Transportation Link Descriptions ....................................................................................3-3 Table 3-4: Administration Menu Screen Descriptions ......................................................................3-4 Table 3-5: Group Information Screen Descriptions ..........................................................................3-5 Table 3-6: User Information Screen Descriptions ............................................................................3-6 Table 3-7: WCMSA Report Options Screen Descriptions ................................................................3-8 Table 3-8: WCMSAP Reports Options Screen Descriptions ............................................................3-9 Table 4-1: Administration Menu Screen for Administrators Descriptions ..........................................4-1 Table 4-2: Group Information Screen Descriptions ..........................................................................4-2 Table 4-3: User Information Screen Descriptions ............................................................................4-3 Table 4-4: User List Screen Descriptions ........................................................................................4-5 Table 4-5: Locked Cases Screen Descriptions................................................................................4-7 Table 5-1: Work List Screen Descriptions .......................................................................................5-2 Table 5-2: Image Search Screen Scenarios....................................................................................5-4 Table 5-3: Image Search Screen Descriptions ................................................................................5-5 Table 5-4: BCRC Data Entry Screen Descriptions...........................................................................5-8 Table 5-5: Beneficiary Information Section Descriptions..................................................................5-9 Table 5-6: Entitlement Information Section Descriptions................................................................5-10 Table 5-7: Diagnosis Information Section Descriptions..................................................................5-11 Table 5-8: Administrator Information Screen Descriptions .............................................................5-12 Table 5-9: Claimant Attorney Information Screen Descriptions ......................................................5-14 Table 5-10: Employer Information Screen Descriptions .................................................................5-14 Table 5-11: Submitter Information Screen Descriptions.................................................................5-15 Table 5-12: WC Carrier Screen Descriptions ................................................................................5-16 Table 5-13: Rep. Payee Information Screen Descriptions .............................................................5-17 Table 5-14: Note Log Descriptions ...............................................................................................5-18 Table 5-15: Settlement Detail Screen Descriptions .......................................................................5-19 Table 6-1: Case List Screen Descriptions .......................................................................................6-4 Table 6-2: Case Information Screen and Button Descriptions..........................................................6-7 Table 6-3: Commingled Letter/Alert History Screen Descriptions ...................................................6-11 Table 6-4: Commingling Letter/Alert Information Screen Descriptions ...........................................6-12 Table 6-5: Beneficiary Information Screen Descriptions ................................................................6-13 Table 6-6: Diagnosis Code Lookup Dialog Descriptions ................................................................6-16 Table 6-7: Administrator Information Screen Descriptions .............................................................6-17 xi

Table 6-8: Claimant Attorney Information Screen Descriptions ......................................................6-18 Table 6-9: Employer Information Screen Descriptions ...................................................................6-18 Table 6-10: Submitter Information Screen Descriptions.................................................................6-19 Table 6-11: WC Carrier Screen Descriptions ................................................................................6-20 Table 6-12: Rep. Payee Information Screen Descriptions .............................................................6-21 Table 6-13: History Screen Descriptions .......................................................................................6-22 Table 6-14: Note Log Descriptions ...............................................................................................6-24 Table 6-15: Settlement Detail Screen Descriptions .......................................................................6-25 Table 6-16: Future Treatment Screen Descriptions .......................................................................6-33 Table 6-17: Major Medical Center ZIP Code Entry ........................................................................6-34 Table 6-18: Prescription Drug Information.....................................................................................6-36 Table 6-19: Pricing Chart (Add/Edit and Existing) .........................................................................6-36 Table 6-20: Drugs Entered by WCMSA Portal User ......................................................................6-37 Table 6-21: Redbook Pricing Rx Search Screen Descriptions .......................................................6-41 Table 6-22: Decision Rationale Screen Descriptions .....................................................................6-47 Table 6-23: Approval Letter History Screen Descriptions...............................................................6-49 Table 6-24: Closeout Letter History Screen Descriptions...............................................................6-51 Table 6-25: Development Letter History Screen Descriptions ........................................................6-52 Table 6-26: Development Letter Information Screen Descriptions .................................................6-54 Table 6-27: Recommendation Letter History Screen Descriptions .................................................6-55 Table 6-28: Re-Review Request History Screen Descriptions .......................................................6-57 Table 6-29: Re-Review Request Screen (Historical) Descriptions..................................................6-58 Table 6-30: Historical Rx Lookup Screen Descriptions ..................................................................6-63 Table 6-31: Re-Review Request Screen Descriptions ...................................................................6-67 Table 6-32: Re-Review Request Dialog Descriptions ....................................................................6-74 Table B-1: WCMSA Reports Main Menu Screen Descriptions ........................................................ B-1 Table B-2: WCMSAP Reports Main Menu Screen Descriptions...................................................... B-3 Table B-3: Production Report Field Descriptions ............................................................................ B-4 Table B-4: WCRC Report Field Descriptions.................................................................................. B-5 Table B-5: WCCCS Quality Assurance Report Field Descriptions .................................................. B-7 Table B-6: WCCCS Inventory Report Field Descriptions ................................................................ B-8 Table B-7: WCCCS Monthly Aged Report Field Descriptions ......................................................... B-9 Table B-8: WCRC Case Count Report Field Description .............................................................. B-10 Table B-9: Case Count by Assigned Operator Report Field Descriptions ...................................... B-11 Table B-10: Case Count by Status Report Field Descriptions ....................................................... B-12 Table B-11: BCRC Work List Counts Report Field Descriptions ................................................... B-13 Table B-12: Monthly Case Counts Field Descriptions ................................................................... B-13 Table B-13: Use Case Counts by Status Report Field Descriptions .............................................. B-14 Table B-14: WCMSA Caseload Report Field Descriptions............................................................ B-16 Table B-15: WCMSA Status Report for Processed Cases Field Descriptions..