The following words and terms when used in this subchapter
will have the following meanings, unless the context clearly indicates
otherwise:
(1) Application acknowledgment code--A code used to
identify the accepted or rejected status of the transaction being
acknowledged.
(2) Claim EDI record--The accurate data associated
with a single claim reported in a claim EDI transaction (first report
of injury or subsequent report of injury) obtained from all sources,
including the report of incident or injury and the insurance carrier's
claim file.
(3) Claim EDI transmission--The data that is contained
within the interchange envelope.
(4) Division--The Texas Department of Insurance, Division
of Workers' Compensation or its data collection agent.
(5) EDI--Electronic data interchange.
(6) Edit Matrix--A table containing the edits applied
to Texas' first report of injury and subsequent report of injury records.
(7) Element requirement table--A table containing data
elements used in Texas' first report of injury and subsequent report
of injury record layouts defining required and conditional data elements
and how data edits apply to the elements.
(8) Event table--A table containing the reportable
claim events for Texas' first report of injury and subsequent report
of injury records and timeframes for reporting the information.
(9) Insurance carrier claim number--An identifier that
distinguishes a specific claim within an insurance carrier's claim
processing system and is used throughout the life of the claim.
(10) IAIABC--The International Association of Industrial
Accident Boards and Commissions.
(11) Person--A person, partnership, corporation, hospital
district, insurance carrier, organization, business trust, estate
trust, association, limited liability company, limited liability partnership,
or other entity. This term does not include an injured employee.
(12) Trading partner--A person entering into an agreement
with the insurance carrier to format electronic data for transmission
to the division, transmit electronic data to the division, and respond
to any technical issues related to the contents or structure of an
EDI file.
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