on Sept 17, 2025 at 8:47 AM

Pending Vote - IRR CLM955 - Update definition of DN0193


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From: Katia Woerner

User Posts: 124 -

Download Attachment IRR CLM955 - Update Definition of DN0193.pdf 91.05 kB 18 downloads
Download Attachment Suspension Effective Date IRR 090525.pdf 93.09 kB 20 downloads

Business Requirement / Issue:
Net to Zero code is not required when reporting intermittent periods of reduced earnings where no payment was issued by claim administrator.

Requester's Proposed Solution:
Edit to definition of DN0193 Suspension Effective Date and Variable Segment Population Rules for Reduced Earnings section d. See attached.

Please note that there was a slight delay in posting this IRR due to an internal review to determine whether the change should be classified as clerical (as originally submitted) or substantive. This request was subsequently updated to substantive

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22 hr 42 min ago Picture for Katia Woerner

From: Katia Woerner

User Posts: 124 -

The voting period for this IRR has begun and will extend through April 14, 2026. A ballot for this IRR was sent to the voting body via email on March 25, 2026. The voting body is comprised of current IAIABC jurisdictional and EDI members in good standing. Each eligible organization is allowed one vote per IRR. It is the responsibility of the designated voter (or the alternate, if the designated voter is not available) to discuss the issue up for vote with all stakeholders within their organization and vote accordingly.

on March 5, 2026 at 6:36 AM Picture for Katia Woerner

From: Katia Woerner

User Posts: 124 -

The final 14-day review period has begun for this IRR and will extend through March 24, 2026. Please respond with any final feedback or objections.

on Feb 19, 2026 at 9:48 AM Picture for Monica Blackwell

From: Monica Blackwell

User Posts: 85 -

Download Attachment IRR CLM955 Update Definition of DN0193.docx 17.46 kB 3 downloads

Claims Committee,

Thank you for the great discussion during the February 18, 2026 call.  There has been one change made to bullet b. of the proposed resolution.  Please review and make post any questions/comments on the Community.

If there are no questions/comments, this IRR will move to 14 day review on March 5th.  

Thank you,

Your Claims Leadership Team

on Jan 22, 2026 at 6:36 AM Picture for Monica Blackwell

From: Monica Blackwell

User Posts: 85 -

Download Attachment IRR CLM955 Update Definition of DN0193.docx 17.24 kB 8 downloads

Claims Committee,

Thank you for the great conversation at the Claims Committee meeting on 1/21/2026.  Please review the attached proposed resolution.  After the call, there was a good suggestion to move the Net to Zero bullet to the end (d.) since it is the outlier and all other bullets are more normal processing. 

We will review and address any comments in the February call on 2/18/2026 before moving the resolution to 14 day review.