Attachment_J.1.1_-_Appendix_A_WCCCS_User_Guide_August_2010.pdf

Workers’ Compensation Case Control System (WCCCS)

User Guide

Rev. 2010-02/August

GHI-DI-450-4.10

ii

Confidentiality and Disclosure of Information

Section 1106 (a) of the Social Security Act as it applies to the Centers for Medicare & Medicaid Services (CMS) - (42 CFR Chapter IV Part 401 §§ 401.101 to 401.152) prohibits disclosure of any information obtained at any time by officers and employees of Medicare Intermediaries, Carriers, or contractors in the course of carrying out agreements under Sections 1816 and 1842 of the Social Security Act, and any other information subject to Section 1106 (a) of the Social Security Act.

Section 1106 (a) of the Act provides in pertinent part that “Any person who shall violate any provision of this section shall be deemed guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine not exceeding $10,000, or by imprisonment not exceeding five years, or both.” Additional and more severe penalties are provided under Title XVIII (Medicare) USC Section 285 (unauthorized taking or using of papers relating to claims) and under Section 1877 of Title XVIII of the Act (relating to fraud, kickbacks, bribes, etc., under Medicare).

These provisions refer to any information obtained by an employee in the course of their performance of duties and/or investigations (for example, beneficiary identification number, beneficiary diagnosis, social security number, pattern of practice of physicians, etc.). Any unauthorized inspection or disclosure of IRS return information in violation of any provision of Section 6103 may bring damages as described in IRC Sections 7431 and 7213, which include, but are not limited to, a fine of any amount not exceeding $5,000 or imprisonment.

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Table of Contents

Chapter 1 : Introduction .......................................................................................................................... 1-1

1.1 What is WCCCS? ................................................................................................................................ 1-1

1.2 WCCCS Workflow .............................................................................................................................. 1-1

1.2.1 COBC Processing ....................................................................................................................... 1-2

1.2.2 WCRC Processing ...................................................................................................................... 1-3

1.2.3 RO Processing ............................................................................................................................ 1-3

1.3 System Interfaces ................................................................................................................................ 1-5

1.4 Authority ............................................................................................................................................. 1-5

1.5 Glossary ............................................................................................................................................... 1-6

Chapter 2 : Basic User and Administrator Tasks ................................................................................. 2-1

2.1 Logging Into WCCCS ......................................................................................................................... 2-1

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

2.3 Basic User Tasks ................................................................................................................................. 2-5

2.3.1 Viewing Your Group Information .............................................................................................. 2-7

2.3.2 Viewing Your User Profile......................................................................................................... 2-9

2.3.3 Changing Your Password From the User Information Screen ................................................. 2-11

2.4 Basic Administrative Task .................................................................................................................. 2-1

2.4.1 Requesting Reports .................................................................................................................... 2-1

Chapter 3 : Administrator-Specific Tasks ............................................................................................. 3-1

3.1 Updating Group Information ............................................................................................................... 3-2

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

3.3 Viewing the User List Screen .............................................................................................................. 3-6

3.4 Updating a User’s Information ............................................................................................................ 3-7

3.5 Resetting a User’s Password ............................................................................................................... 3-9

3.6 Resetting the Password of a User at Another Location ..................................................................... 3-10

3.7 Case Locking Maintenance ............................................................................................................... 3-11

Chapter 4 : COBC Imaging and Initial Data Entry ................................................................................. 4-1

4.1 COBC Image Screens .......................................................................................................................... 4-1

4.1.1 Work List Screen ........................................................................................................................ 4-1

4.1.2 Image Search Screen .................................................................................................................. 4-4

4.2 COBC Data Entry Screens .................................................................................................................. 4-1

4.2.1 Data Entry Screen ....................................................................................................................... 4-2

4.2.2 Claimant Tab .............................................................................................................................. 4-4

4.2.3 Diagnosis Codes Tab .................................................................................................................. 4-5

4.2.4 Representative Payee Tab .......................................................................................................... 4-7

4.2.5 WC Carrier Tab .......................................................................................................................... 4-8

4.2.6 Submitter Tab ............................................................................................................................. 4-9

4.2.7 Note Log Tab ........................................................................................................................... 4-10

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4.2.8 Claimant Attorney Tab ............................................................................................................. 4-11

4.2.9 Employer Tab ........................................................................................................................... 4-11

Chapter 5 : WCRC and RO Workflow ..................................................................................................... 5-1

5.1 Case List Screen .................................................................................................................................. 5-3

5.2 Case Information Screen ..................................................................................................................... 5-7

5.2.1 Claimant Info Tab .................................................................................................................... 5-10 Diagnosis Codes and Description Screen ........................................................................... 5-12

5.2.2 Contact Information Tab .......................................................................................................... 5-14 Administrator Sub-Tab ....................................................................................................... 5-14 Claimant Attorney Sub-Tab ................................................................................................ 5-16 Employer Sub-Tab .............................................................................................................. 5-17 Submitter Sub-Tab .............................................................................................................. 5-18 WC Carrier Sub-Tab ........................................................................................................... 5-19 Rep Payee Sub-Tab ............................................................................................................. 5-20

5.2.3 History Tab ............................................................................................................................... 5-21

5.2.4 Note Log Tab ........................................................................................................................... 5-23

5.2.5 Settlement Detail Tab ................................................................................................................. 5-1

5.2.6 Recommendations Tab ............................................................................................................... 5-5

Treatment Status and Unrelated Treatment Sub-Tabs .......................................................... 5-5 Future Treatment Sub-Tab .................................................................................................... 5-5 Pharmacy Sub-Tab ................................................................................................................ 5-8 Searching for the lowest priced drug .................................................................................. 5-12 Deleting an existing drug in a case ..................................................................................... 5-19 Decision Rationale Sub-Tab ............................................................................................... 5-20

5.3 Development Letter History Screen .................................................................................................. 5-23

5.3.1 Development Letter Information Screen .................................................................................. 5-25

5.4 Approval Letter History Screen......................................................................................................... 5-27

5.4.1 Approval Letter Information Screen ........................................................................................ 5-29

5.5 Recommendation Form History Screen ............................................................................................ 5-32

5.6 Letter Archive .................................................................................................................................... 5-34

5.7 Historical Rx Lookup function .......................................................................................................... 5-36

Appendix A : System Flowchart ............................................................................................................ A-1

Appendix B : Reports ..................................................................................... Error! Bookmark not defined.

B.1 WCCCS Production Report ................................................................... Error! Bookmark not defined.

B.2 WCCCS Quality Assurance Report ....................................................... Error! Bookmark not defined.

B.3 WCCCS Inventory Report ..................................................................... Error! Bookmark not defined.

B.4 WCCCS Monthly Aged Report ............................................................. Error! Bookmark not defined.

B.5 WCRC Production Report ..................................................................... Error! Bookmark not defined.

B.6 WCMSA Status Report for Processed Cases ........................................ Error! Bookmark not defined.

B.7 WCMSA Status Report for Pending Cases ........................................... Error! Bookmark not defined.

B.8 WCMSA Summary Report.................................................................... Error! Bookmark not defined.

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B.9 WCMSA Summary Backlog Report ..................................................... Error! Bookmark not defined.

B.10 WCMSA Regional Office Pending DREC Case Inventory ReportError! Bookmark not defined.

B.11 WCMSA Regional Office Pending DISP Case Inventory ReportError! Bookmark not defined.

B.12 WCMSA Regional Office Pending ASGN Case Inventory ReportError! Bookmark not defined.

B.13 WCMSA Regional Office Pending RECD Case Inventory ReportError! Bookmark not defined.

B.14 WCMSA Caseload Report ........................................................... Error! Bookmark not defined.

Appendix C : Document Management System .................................................................................... B-1 C.1 Viewing Functions ............................................................................................................................. B-2 C.2 Annotations (Internet Explorer Only) ................................................................................................ B-3 C.3 Adding Bookmarks ............................................................................................................................. B-6 C.4 Changing Document Type .................................................................................................................. B-8

Appendix D : Sample Documents ......................................................................................................... C-1 D.1 Recommendation Form ...................................................................................................................... C-1 D.2 Arrangement Proposal Cover Letter Requirements ............................................................................ C-4 D.3 Lump Sum Form ................................................................................................................................ C-8 D.4 Self Structured Attestation Form ........................................................................................................ C-1 D.5 Old Self Structured Attestation Form ................................................................................................. C-5

Appendix E : Letters ............................................................................................................................... D-1 E.1 Mailing Schedule for WCCCS Letters ............................................................................................... D-1 E.2 Acknowledgement Letter ................................................................................................................... D-2 E.3 Approval Letter .................................................................................................................................. D-4 E.4 Professional Attestation Letter ........................................................................................................... D-1 E.5 Closeout Letter ................................................................................................................................... D-3 E.6 Deny Letter ......................................................................................................................................... D-4 E.7 Development Letter ............................................................................................................................ D-6 E.8 Under Threshold Letter .................................................................................................................... D-12 E.9 Beneficiary Under Threshold Letter ................................................................................................. D-13 E.10 Zero Set-Aside Letter .............................................................................................................. D-15

Appendix F : Foreign Address Layout ...................................................................................................E-1

Appendix G : WCCCS Action vs COB and MBD Records ........................... Error! Bookmark not defined.

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Notes:

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Chapter 1: Introduction

This chapter contains an introduction to the Workers’ Compensation Case Control System (WCCCS). See Appendix A for a system flowchart.

1.1 What is WCCCS?

The Workers’ Compensation Case Control System (WCCCS) is a reporting and tracking system for Workers’ Compensation Medicare Set-aside Arrangement (WCMSA) cases. WCCCS creates transactions via the COB batch application in order to transmit HUSP records to the Common Work File (CWF) located at CMS and provide the Lead Contractor with notification and information regarding the cases.

This is further outlined in Appendix G: WCCCS Action vs COB and MBD Records.

1.2 WCCCS Workflow

A WCMSA case is initially received, scanned, and entered by the Coordination of Benefits Contractor (COBC) to create a regular workers compensation record (MSP type = ‘E’) at CWF. When the COBC completes these activities and submits the case, it is systematically assigned to the Workers’ Compensation Review Contractor (WCRC) where the case information is evaluated and a recommendation is developed. An authorized user at the WCRC then submits the case to the RO that was assigned to the case based on the claimants state of residence and CMS’ state/region logic. The RO reviews the WCRC recommendation and completes the case. After completion, the COB application updates the records at CWF with the final disposition of the case.

As a case travels through this system from start to finish, it is identified by various locations and statuses.

The system creates an audit trail at pre-defined intervals, as well as whenever a case is assigned to one individual from another. The possible status and location codes and their descriptions are listed below.

Locations Status Description

COBC INVD Invalid Scanned Document

PEND Pending

SCND Scanned

WCRC RECD Case Received

REOP Case Reopened (after RO/CLOS)

CLTR Closeout

RO APPR Approval Letter Generated

ASGN Assigned

BUND Beneficiary Under Threshold

CLOS Manually Closed

COMP Case Completed (generates Workers’ Compensation Set-Aside (WCSA) HUSP)

DECD Deceased

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DENY Case Denied (unable to process case)

CLTR Closeout

DEVP In Development

DISP WCRC Recommendation Completed (at RO)

DREC Development Received

OPCM Case Reopened (after RO/COMP)

RECD Received from another RO

RTND Under Threshold – Non-Bene Case (No CMS Review)

ZERO Zero Set-aside

Note: All Location and Status codes are written as LOCATION/STATUS in this manual.

1.2.1 COBC Processing

WCMSA cases are submitted to the COBC via paper or CD-Rom. The COBC then performs the following tasks. The LOC/STATUS is included for each task.

1. Prepares, sorts, and scans all of the case documents received (COBC/SCND).

2. A COBC user selects a case to work. The system requires the COBC user to search the Coordination of Benefits (COB) database to determine if the case is new or if it should be appended to an existing case. A function within the WCCCS provides the ability to search for existing cases by SSN or HICN. If the document does not belong in the WCCCS, the auditor closes the case with COBC/INVD and forwards a screen print of the image to the appropriate entity.

3. If the document is appended to an existing case, the system removes the item from the COBC Work List screen once it is appended to an existing case. The status of the case then changes to Development Received (RO/DREC).

4. If the COBC user determines that the case is new, the system displays a series of data entry screens.

The user is required to enter the information necessary to create a Workers’ Compensation (WC) auxiliary record at CWF and as many data entry fields that are available from the documentation.

5. The user is required to enter a Social Security Number (SSN) or a Health Insurance Claim Number (HICN). If a HICN is entered, the user must select the GO button . This causes the system to search the COB database for the beneficiary information attached to the HICN. If the data is found, the system pre-fills the Claimant Tab with the relevant data.

6. If the documentation does not contain the critical data elements to establish a WC record, the COBC performs development via telephone or letter through CCORS to obtain the information.

The case remains in pending status until the COBC completes processing (COBC/PEND).

7. Once the COBC enters the critical data elements, the case is submitted to the WCRC for further processing (WCRC/RECD).

8. If the system found a date of death for a beneficiary, the case changes to a deceased status and is then assigned directly to the RO when the case is submitted (RO/DECD).

9. At this time an acknowledgement letter is sent to the submitter. The purpose of the acknowledgement letter is to inform the submitter that the case has been received and to provide a website address that contains the checklist of the items that should be submitted with the case. The system generates a letter transaction to be transmitted to United Systems of Arkansas (USofA) for printing and mailing.

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10. A WC Medicare Secondary Payer (MSP) occurrence is created and transmitted to CWF. If the individual is a Medicare beneficiary, has a Part D enrollment date that is on/after 1/1/06, and prescription drugs are included in the Pharmacy tab by the selection of the appropriate radio button, a transaction is also created and transmitted to the Medicare Beneficiary Database (MBD) to post a drug record.

1.2.2 WCRC Processing

The WCRC is the next entity to receive the case. The WCRC reviews the case information in detail and makes recommendations as to the disposition of the case, the prescription drugs proposed and costs, treatment plans and costs and WCMSA amount.

During the review, the WCRC may need to develop for additional information or documentation (WCRC/DEVP). If a response to development has not been received within 30 days of the request for development, the status of the case changes to Closeout (WCRC/CLTR). If the response to the development request is insufficient, another request can be sent to the submitter. If more than one Development Letter has been sent, the timestamp of the most recent Development will be used to calculate the 30 days.

When the WCRC completes its review and recommendation, the case is submitted to an RO.

1.2.3 RO Processing

The RO assigned to the case is based on the state of residence of the beneficiary (RO/DISP). A case may be transferred from one RO to another (RO/RECD) based on the cases State of Venue, or because the RO the case was originally assigned to has closed.. The LOC/STATUS is included for each task.

1. Based on the recommendation provided by the WCRC, the RO may determine that the case does not qualify as a WCMSA case because it does not meet CMS’ review threshold with regard to individuals with a reasonable expectation of becoming a beneficiary within 30 months of the WC settlement. The RO selects the Under Threshold radio button under the Payout Total radio buttons on the Settlement Detail tab (RO/RTND). This action then generates an Under Threshold letter and can be viewed under Letter Archives.

2. Based on the recommendation provided by the WCRC, the RO may also determine that the case does not qualify as a WCMSA case because it does not meet the CMS review threshold with regard to individuals who are Medicare beneficiaries. The RO selects the Beneficiary Under Threshold radio button under the Payout Total radio buttons on the Settlement Detail tab. This action then generates a Beneficiary Under Threshold letter and can be viewed under Letter Archives

(RO/BUND).

3 If the claimant becomes deceased during CMS’ review of the WCMSA case submitted and a date of death with supporting documentation, if requested, is provided, then a date of death is entered into the system. The status of the case changes to deceased (RO/DECD).

4. Any RO user may assign a case to a specific individual within his/her office to work. The administrator also has the option of allowing the analysts to assign themselves cases (RO/ASGN).

The RO user may submit a case back to the WCRC in which the case will change its status to received (WCRC/RECD).

5. The RO may need to develop for additional information. Within the WCCCS, there is a Development Letter screen that allows the RO to select the information/documentation necessary to continue processing the WCMSA case from the submitter. The system then creates a mail transaction to send to USofA for printing and mailing (RO/DEVP). If a response is not received within 30 days, the status of the case changes to Closeout status (RO/CLTR). When documentation is scanned at COBC while the case is at the RO, the status of the case changes to development

1-4 Rev. 2010-31/March received (RO/DREC).

6. The RO may determine that the case should be closed for a number of reasons (RO/CLOS). If such a case is later reopened due to additional documentation, it is marked as Reopened and systematically assigned to the WCRC (WCRC/REOP). A HUSP record is sent to CWF indicating that a WCMSA case is pending for the claimant.

7. The RO reviews the WCRC’s recommendation and makes a determination as to the final WCMSA amount. When the final WCMSA amount is determined by the RO, then the RO selects the Approved radio button under the Payout Total radio buttons on the Settlement Detail tab. The status of the case changes to approved (RO/APPR).

8. The approval letter is generated when the case is in approved status. An attachment is also generated with the approval letter based upon the information populated under the Contact Info tab (i.e., self-administered, professional administered, or representative payee). Letter transactions are sent to USofA for printing and mailing. The case is updated with the mail date in the History Log when a response is received from USofA.

9. After receiving the final settlement agreement, according to the applicable State law, the RO enters the final settlement date into the Settlement Date field on the Settlement Detail tab in order to complete the case (RO/COMP). A case may be reopened once completed (RO/OPCM), but no changes to CWF or MBD records will occur.

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1.3 System Interfaces

WCCCS interfaces with the COB system. COB is updated based on the activity within WCCCS. This facilitates the interfaces between COB, MBD, and CWF. Below is a description of the interfaces that occur. The LOC/STATUS are included where appropriate.

1. When an image is scanned with the new batch number, the image software places the image on ViPS’ web server where the WCCCS can access it. The image software supplies a unique batch number, image name, and scan date. Once scanned, the status of the image is scanned (COBC/SCAN).

2. When the COBC first performs data entry of new cases, a HICN is entered if one is provided. If no HICN is provided, the WCCCS queries the COB Beneficiary Master table for the HICN. If it exists, some of the beneficiary data is pre-filled on the WCCCS data entry screens.

3. COBC auditors submit the data entry screens to the WCCCS for processing. The location and status in WCCCS are set to WCRC/ASGN. The COB application creates a record with all the data elements needed to post an MSP occurrence at CWF and, if applicable, a drug record at MBD. The COB system will process the WCSA record and continue to notify the lead contractor. If the COB system finds the individual on the Beneficiary Master table, a row is inserted on the Case Coverage table, and then a HUSP transaction is created and sent to CWF. When the CWF reply is received, the ECRS values within the case are set to HD50 (holding for final disposition).

4. The HUSP record processes in the nightly batch cycle. Once the reply is received, the ECRS values in the WCCCS case is set to HD50 (holding for final disposition).

5. The RO makes the final determination as to whether a WCMSA case qualifies for CMS’ review. In the WCCCS, the RO marks the case as Under Threshold or Beneficiary Under Threshold. This sets the location and status in the WCCCS to RO/RTND. It also closes the case and sets the ECRS values to CM89 (closed for under threshold).

6. When the RO enters a date of death in the WCCCS, the location and status in the WCCCS are set to deceased (RO/DECD). The ECRS values within the record are set to CM65 (deceased). If the claimant was entitled to Medicare, the WC MSP record will be terminated with the date of death.

7. When the RO enters a final settlement date on the Settlement Detail tab in order to complete the case in the WCCCS, the location and status in WCCCS are set to RO/COMP. A transaction is created in the batch cycle to transmit the WC Set-aside record to CWF and to terminate the pending WC record.

Once the reply is received from CWF, the ECRS values in the WCCCS case are set to CM50 (change applied at CWF).

8. If the COB system cannot find the claimant on the Beneficiary Master table with an active record where the Part A entitlement date is not in the future, the case is placed on hold and recycled daily until the claimant becomes Part A entitled. Once this happens, the HUSP record to apply the pending WCMSA occurrence is created for submission to CWF. If the case is approved and the final settlement date has been reached, the HUSP records to terminate the pending WCMSA occurrence and open the final WCMSA occurrence is created and submitted to CWF

1.4 Authority

There are two levels of authority within WCCCS: at these locations COBC/RO/WCRC (Administrator or user).

Administrators have the authority to:

• Assign cases

• Add new users

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• Reset passwords

• Edit user profiles

• Unlock cases

• Edit group information

Users (with edit authority) have the ability to make additions and updates to the system.

Each location must designate more than one administrator. This is necessary so that in the event one administrator is out, another administrator is available to reset passwords, etc.

Each RO is assigned a group ID. These group IDs are designated prior to implementation; administrators do not have the authority to create additional group IDs.

Each group’s administrator is responsible for setting up users within that group.

1.5 Glossary

Acronym Definition CMS Centers for Medicare & Medicaid Services

COB Coordination of Benefits

COBC COB Contractor

CWF Common Work File (located at CMS)

ECRS Electronic Correspondence Referral System

HICN Health Insurance Claim Number

HUSP Name of the transaction record used to update MSP records at CMS

MBD Medicare Beneficiary Database

MSA Medicare set-aside amount

MSP Medicare Secondary Payer

PSD Proposed Settlement Date

RO Regional Offices

USA United Systems of Arkansas

WC Workers’ Compensation

WCCCS Workers’ Compensation Set-Aside Case Control System

WCMSA Workers’ Compensation Medicare Set-aside Arrangement

WCRC Workers’ Compensation Review Contractor

WCSA Workers’ Compensation Set-Aside

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Chapter 2: Basic User and Administrator Tasks

If you have been assigned as a User, basic user tasks allow you to view group information and user profiles, and change passwords.

2.1 Logging Into WCCCS

If you have been assigned as a User, you may access the WCCCS by typing the WCCCS address (32.91.241.116) in an Internet Explorer browser window. Once connected, the WCCCS Logon screen displays, as shown in the example below.

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Screen Description

Logon Screen

Label Description

Group ID Drop-down box used to select your group ID. Values are:

Atlanta Boston Central Office Chicago Dallas Denver

GHI

Kansas City New York Philadelphia San Francisco Seattle WC Review Contr

User ID User’s ID. The User ID cannot be more than 8 characters.

Password Password. The password must be 6 to 8 alphanumeric characters.

How to Proceed

1. Select your Group ID from the Group ID drop-down list.

2. Tab to the User ID field and enter your user ID.

3. Tab to the Password field and type your password. If you are logging on for the first time, you have a default password of CHANGEME. (Note: Both User ID and password are case sensitive–that is, upper and lower case do matter. The password is always in all upper-case letters.)

3. Click the Log In button or press [Enter].

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2.2 Changing Your Password at First Sign In and Every 60 Days When you log in to the WCCCS for the first time and every 60 days thereafter, the Change Password screen displays.

You are required to change your password from the default that was initially assigned to you (“CHANGEME”). The rules for creating passwords are as follows:

• A password must be 6 to 8 alphanumeric characters long.

• Passwords are case sensitive, that is, the system distinguishes between upper and lower case.

• You must change your password after logging in for the first time, and then again every 60 days.

• The password will always be in all upper case letters.

Screen Description

Change Password Screen

Label Description

Current Password Current password or administrator defined default password.

New Password New password.

Repeat New Password Retype new password.

Submit Updates the password change.

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How to Proceed

1. Type your current password in the Current Password field.

2. Type your new password in the New Password field.

3. Re-type your new password in the Repeat New Password field.

4. Click Submit. The system changes your password.

If you forget your password, an administrator can reset it for you.

Transportation Links

Seven transportation links appear at the top right of every screen in WCCCS. You can use these links to quickly navigate through the system. Clicking one of the transportation links closes your current window and opens the window you selected.

Refer to the table below.

Click this link… To do this…

Work List Displays the COBC Work List screen.

Note: If you are a COBC user, this screen automatically displays each time you log on. See Chapter 4 for more information about this screen.

Case list Displays the RO Case List screen.

Note: If you are an RO user, this screen automatically displays each time you log on. See Chapter 5 for more information about this screen.

Administration Displays the Administration Menu, which is explained in more detail in this chapter.

Archives Allows user to perform a search of letters for a selected case.

Reports Displays the Reports Menu, which is explained in more detail on the following pages.

Rx Lookup Displays Redbook drug information for drugs. See Section 5.7, below

Logoff Logs off of WCCCS.

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2.3 Basic User Tasks

Users have the authority to view their group information and user profiles and change their passwords.

These tasks are available through the Administration Menu screen. If you are an administrator, refer to Chapter 3 for administrator-specific information about this screen.

How to Access the Administration Menu

1. Log on to WCCCS.

2. Click the Administration link at the top right of the screen. The Administration Menu screen for Users

Screen Description

Administration Menu Screen for Users

Label Description

Group Maintenance

My Group Selects the Group Information screen. This screen displays information about the GroupID that the user is associated with.

User Maintenance

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Administration Menu Screen for Users

Label Description

My Profile Selects the User Profile screen. This screen displays user information and allows the user the option to reset their password.

Note: The user information is display only and the data cannot be changed by a user. This information can only be updated by the administrator for that region.

GO buttons Transports you to the screen you selected.

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2.3.1 Viewing Your Group Information

The Group Information screen is for inquiry only. Only group administrators can make updates to group information. (If you are an administrator, see Chapter 3.) Follow the steps below to view the group profile.

1. Log on to WCCCS.

2. Click the Administration link. The Administration Menu screen displays.

3. Under Group Maintenance, click the My Group radio button and the Go button.

4. The Group Information screen displays, as shown in the example below.

Group Information Screen

Label Description

Group ID Your group identification number.

Update Date The month, day, and year of the last update made to the group profile.

Display Name Name of the group.

Update ID Operator ID of the last person to add or change the group profile.

Contact Name Name of the group administrator.

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Group Information Screen

Label Description

Email Email address of the group administrator.

Phone Phone number of the group administrator.

Fax Fax number of the group administrator.

Physical Address Address of the group.

Mail Address Same as Physical button

This button is active for Administrators only.

Mail Address Mailing address if different from the physical address.

Done Button Returns user to the Administration Menu screen

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2.3.2 Viewing Your User Profile

Except to change your password, the User Information screen is for inquiry only. Only administrators can make updates to personal information. (If you are an administrator, see Chapter 3.) Follow the steps below to view your profile.

1. Log on to WCCCS.

2. Click the Administration link. The Administration Menu screen displays.

3. Under User Maintenance, click the My Profile radio button and click the Go button.

4. A completed User Information screen displays, as shown in the example below.

User Information Screen

Label Description

Group ID Name of Group

User ID User ID.

First Name User’s first name.

Last Name User’s last name

Phone User’s phone number.

Email User’s email address.

Update Date The month, day, and year of the last update made to the user profile.

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User Information Screen

Label Description

Update Operator Operator ID of the last person to add or change the user profile.

Edit Authority Indicates whether or not you have authority to make adds and updates to WCCCS.

(See Chapter 3 for procedures.)

Admin Indicator Indicates whether or not you have group administrative authority. (See Chapter 3 for procedures.)

Assign Indicator Indicates whether or not you have authority to assign cases from the WCRC to the ROs.

Note: This indicator is active only for the WCRC.

Upload Indicator Indicates whether or not you have authority to upload letter templates.

Note: This indicator is active only for CMS Central Office.

Auto Save (minutes) Indicates how often (in minutes) case information is automatically saved.

Change Password hyperlink

Displays the Change Password screen. See “Changing Your Password From the User Information Screen” below.

Done button Click this button when you are finished viewing the screen .

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2.3.3 Changing Your Password From the User Information Screen

As a User, you can change your password at any time. Follow the steps below.

1. From the User Information screen, click the Change Password link. The Change Password screen

2. Type your current password in the Current Password field.

3. Type your new password in the New Password field.

4. Retype your new password in the Repeat New Password field.

5. Click Submit. The system saves your new password. Or click Return to return to the previous screen without saving changes.

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2.4 Basic Administrative Task

2.4.1 Requesting Reports

If you have been assigned as a CO, COBC, or WCRC administrator, you have the authority to generate and view certain reports. Access to the Report Options screen is explained below. The specific reports are further explained in Appendix B.

How to Access the Reports Menu

1. Log on to WCCCS. The Case List screen is displayed.

2. Click the Reports hyperlink on the black bar at the top right of the screen. The Report Options screen

Report Options Screen

Label Description

Select Report

Production Report Captures processing statistics for COBC operators. Available only for Central Office and COBC administrators.

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Report Options Screen

Label Description

Quality Assurance Used for performing QA audits on COBC representatives. Available only for Central Office and COBC administrators.

Inventory Report Summarizes case received, pending, and processed by COBC. Available only for Central Office and COBC administrators.

Aged Report Used for tracking aging cases in New and Pending status at COBC. Available only for Central Office and COBC administrators.

WCRC Report Tracks the progress of cases submitted from COBC to the WCRC and from the WCRC to the ROs. Available only for Central Office and WCRC administrators.

Case Load Report Used for tracking Case load for a specific region or all regions . Available only for Central Office and COBC administrators.

WCMSA Report Produces various WCMSA reports. See Appendix B for further information regarding reports that can be generated under this option.

Case Count Produces count of cases for a specific region based upon date criteria

Report Period

From Date Enter a beginning date for the report criteria.

To Date Enter an ending date for the report criteria.

Cancel button Returns you to the Case List screen without generating report.

Generate Report button Generates the selected report.

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Notes:

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Chapter 3: Administrator-Specific Tasks

Administrators have the authority to add new users, edit their group information, reset passwords, and edit user profiles.

How to Access the Administration Menu for Administrators

1. Log on to WCCCS.

2. Click the Administration link. The Administration Menu screen for Administrators displays. Note: As a COBC administrator, an additional option is displayed under Group Maintenance for Existing Group. A sample screen is shown below.

Chapter 3: Administrator-Specific Tasks WCCCS User Guide

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Screen Description

Administration Menu Screen for Administrators

Label Description

Group Maintenance

Existing Group Only for COBC Administrators.

My Group Selects the COBC/RO/WCRC Group Information screen.

User Maintenance

Add New User Selects a blank User Profile screen.

User List Selects the COBC/RO User List.

My Profile Selects the User Profile screen.

Case Locking Maintenance

Manage Locked Cases Selects the Locked Case Manager screen.

GO buttons Transports to the screen you selected.

3.1 Updating Group Information

Group information is pre-loaded prior to the implementation of the WCCCS. Only administrators can update this information.

1. From the Administration Menu screen, click the My Group radio button.

2. Click the Go button. The Group Information screen appears, as shown in the example below.

WCCCS User Guide Chapter 3: Administrator-Specific Tasks

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Screen Description

Group Information Screen

Label Description

Group ID Your group identification number.

Update Date The month, day, and year of the last update made to the group profile.

Update ID Operator ID of the last person to add or change the group profile.

Display Name Name of the group.

Contact Name Name of the group administrator.

Email Email address of the group administrator.

Phone Phone number of the group administrator.

Fax Fax number of the group administrator.

Physical Address Address of the group.

Mail Address Same as Physical button

Indicates whether the mailing address is identical to the physical address.

Mail Address Mailing address, if different from the physical address.

Done button Submits changes.

Edit button Enables the fields for updating.

After pressing the Edit button, a second screen with the following buttons appears that allows you to change information.

Cancel button Cancels any changes made. The screen returns to the previous User Information screen, unchanged

Update button Updates the new User information and returns to the previous screen with the updated information.

3. To make changes to this screen, click the Edit button. The system enables the fields for updating.

4. Update the fields as necessary and click the Update button.

5. Click Done. The system saves your changes.

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3.2 Adding a New User

Administrators have the authority to add new WCCCS users for their group. Follow the steps below.

1. From the Administration Menu screen, click the Add A New User radio button under User Maintenance.

2. Click Go. A blank User Information screen displays, as shown in the example below.

3. After pressing the Edit button, a second screen with Cancel and Update buttons appears that allows you to add/change information. User IDs must be less than 40 characters.

4. When you have completed the screen, click Update. The system saves the new user’s information and returns to the previous screen with the updated information.

5. When finished, press the Done button.

Label Description

Group ID Your group identification number.

User ID User ID of the last administrator to add or change the user profile.

First Name First name of the new user.

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User Information Screen

Label Description

Last Name Last name of the new user.

Phone Phone number of the new user.

Email Email address of the new user.

Update Date The month, day, and year of the last update made.

Update Operator Name of the updating operator.

Edit Authority Allows the new user to have edit authority in addition to view only capability.

Admin Indicator Allows the new user to have administrative authority in addition to view only capability.

Assign Indicator Allows the new user to assign cases to the ROs in addition to view only capability.

Note: This indicator displays for the WCRC only.

Upload indicator Allows the new user to upload letter templates.

Note: This indicator displays for CMS Central Office only.

Auto-Save minutes Sets the Auto-Save time period for the new user

Values are :

Off – Auto-Save function off 5 – five minutes 10 – ten minutes 15 – fifteen minutes 20 – 20 minutes 25 – 25 minutes 30 – 30 minutes

Deactivate User Deactivates user’s account in the WCCCS System.

Change Password Hyperlink that transports user to the Change Password screen to allow the password to be changed to a specific values.

Reset Resets the password to “CHANGEME”.

Done button Submits changes.

Edit button Enables the fields for updating.

After pressing the Edit button, a second screen with the following buttons appears that allows you to add/ change information.

Cancel button Cancels any changes made. The screen returns to the previous User Information screen, unchanged.

Update button Updates the new User information and returns to the previous screen with the updated information.

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3.3 Viewing the User List Screen

Administrators can view a list of the users in their group by accessing the User List screen.

1. From the Administration Menu screen, click the User List radio button.

2. Click the Go button. The User List screen displays, as shown in the example below. (NOTE:

Additional fields can be viewed by moving the horizontal scroll bar to the right)

User List Screen

Label Description

User ID COBC, RO, or WCRC user ID.

Group ID User’s Group ID.

First Name First name of the user.

Last name Last name of the user.

Admin Indicates authority to perform administration functions. Valid values are:

Y = Yes N = No

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User List Screen

Label Description

Edit Indicates authority to perform updates to WCCCS. Valid values are:

Y = Yes N = No

Email Email address of the user.

Phone Phone number of the user.

How to Proceed

Click on a User ID to transfer to that user’s User Profile screen. To update a user’s profile, see the following pages.

3.4 Updating a User’s Information

Administrators have authority to update a user’s information. Follow the steps below.

1. From the Administration Menu screen, click the User List radio button.

2. Click Go. The system displays the User List screen.

3. Click the User ID of the user you wish to update. The system displays that user’s User Information screen, as shown in the example below.

4. Click the Edit button. The system enables the fields for updating and displays the Cancel and Update buttons.

5. Update the information as necessary and press the Update button when done.

6. The system saves your changes and returns to the previous screen with the updated information.

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7. Press the Done button when done.

Label Description

Group ID Drop-down box indicating a group ID.

User ID User name.

First Name User’s first name.

Last Name User’s last name.

Phone The user’s phone number.

Email The email address of the user.

Update Date The month, day, and year of the last update made to the user profile.

Update Operator Operator ID of the last person to add or change the user profile.

Edit Authority Drop-down box with a selection of Yes or No. Edit authority marked yes gives authority for the user to make adds and updates to the WCCCS.

Admin Indicator Drop-down box with a selection of Yes or No. An administrator indicator marked Yes gives group administrative authority to the user.

Assign Indicator Drop-down box with a selection of Yes or No.