Iowa Jurisdictional Notice to Adopt or Transition

EDI Standards: Jurisdictional Notice to Adopt or Transition This form is to be completed and submitted by a jurisdictional member pursuing adoption or transition of an IAIABC EDI Standard. The form is not intended to be a formal commitment. The information provided will be used for internal planning purposes to ensure the availability of resources to support the jurisdiction’s implementation plan. The form should be completed using the most current information available. Subsequently, the jurisdiction is asked to advise when a deviation or change to their implementation plan occurs.


Today’s Date: Jurisdiction:

Iowa Standard: Claims


Release 3.1



Janna Martin, Assistant Workers’ Compensation Commissioner

EDI Contact:


EDI Contact Phone:

EDI Contact Email:

Dave Moraniec, Project Manager (IWD PMO)

Project Manager:


Project Manager Phone:

Project Manager Email:


Vendor (if applicable) :

Robbie Tanner 201-294-0830

Vendor Contact:

Vendor Phone:

Project Contacts

Vendor Email:

12-3-18 (4 th )

Target Implementation (Quarter-Year): Availability of Draft Trading Partner Tables:

1-13-18 Implementation Team, 2-2-18 Post to Iowa EDI Website

Rulemaking, IT Resources, New Jurisdiction Integrated EDI Case Management System New IAIABC Release 3.1 Standards and Trading Partner Implementation & Testing and IAIABC Imp Team support of the same.

List any Project Dependencies: (e.g.: rulemaking, funding, IT resources, scheduling, etc.)

Additional Information and Implementation Notes:

Implementation Details

Internal Use Only:

Implementation Team Contact: Date Trading Partner Tables Approved: Date State Guide Approved: Date Test Plan Reviewed:

Testing Partner(s):

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