Current through Register Vol. 35, No. 11, June 11, 2024
Section 11.4.2.7 - DEFINITIONSA. "American standard code for information interchange (ASCII)" means a code that follows the proposed standard for defining codes for information exchange between equipment produced by different manufacturers.B. "Claims administrator" means the insurance carrier, third party administrator, self-insured association, self-insured employer, or any claims coordinator, if any, designated by the employer or another claims payer to provide claims processing services on workers' compensation claims. These services include receiving and sending workers' compensation claims information to the WCA, employer, insurance carrier, and injured worker.C. "EDI" means electronic data interchange.D. "Loss run" means a computer generated report, listing or file that provides uniquely identifying and financial data of each individual claim for a group of claims occurring during a particular period for an insured or employer.E. "Industry" means a business, or all businesses, as the context requires, that have identical two digit NAICS codes as determined by the WCA.F. "NAICS code" means a designator of the principal business of an employer assigned by the WCA pursuant to the current version of the North American industry classification system, a publication of the executive office of the president, office of management and budget, United States.G. "Experience modifier" is a calculation that compares the losses of an individual risk (employer) to average losses for all other risks in that industry classification and state. The experience modifier is used to adjust the insurance premiums of an individual risk according to the risk's loss experience.H. "FROI" means first report of injury data (IAIABC 148 format). FROI also refers to WCA form E-1 and WCA form E-1.2.I. "SROI" means subsequent report of injury data required to complete the notice of benefit payment (IAIABC A49 format). SROI also refers to WCA form E-6.J. "TA" means transmission accepted.K. "TE" means transmission accepted with errors.L. "TR" means transmission rejected.6/1/96; 4/30/98; 11.4.2.7 NMAC - Rn & A, 11 NMAC 4.2.7, 11/30/04; A, 4/16/12, Adopted by New Mexico Register, Volume XXVII, Issue 18, September 30, 2016, eff. 9/30/2016