This schema describes the structure of XML files that are submitted by caregivers to Saskatchewan Workers' Compensation Board for reimbursement of services provided to injured workers. Types that are not prefixed by "xs:" are internally defined
This is the root element and, as such, can only appear once in the XML document. It corresponds to a group (which could be 1 but may be more) of invoices a caregiver is submitting. This group of invoices may be referred to as a "batch" or "batch submission".
The detail complex type
The MSB/WCB fee code that corresponds to the service that was performed.
The fee code must be 4 characters or less.
The service date the treatment was performed. When the treatment is for physiotherapy treatment, this should correspond to the billing start date.
Only in that case, the date doesn't necessarily correspond to the date the treatment was performed. If a billing period exists, this date must fall within that period.
When a billing period is specified (due to certain fee codes requiring a billing period), the fee codes that are causing the requirement for a billing period to exist must have treatment service dates matching the billing period start date.
The number of times a treatment was performed. Usually, this is 1. However, when the treatment is for physiotherapy treatment, the value is often 2 or more.
This situation indicates a number of the same treatments within a billing period that may not have actually occurred on the same date.
This value can only be greater than 1 if the fee code specified can be invoiced multiple times on the same service date.
If treatments are associated with a multiple unit fee code, those treatments must be rolled up into one line item. For example, do not include 3 line items for fee code 2008, each for 1 unit; rather, calculate the sum of the units for the line items and include only 1 line item (1 line item for 3 units of fee code 2008).
This is usually 1, but can range from 0 to 1000. Decimals are allowed, to some degree.
The base amount used by WCB is not valid in some situations and must be specified by the caregiver. This field's purpose is to capture that amount.
The field may only be specified when the base amount can be overridden.
This is a dollar amount and must be greater than 0.
This field specifies the drug name that was prescribed by the caregiver. It should only be specified when the "Prescription Drugs" fee code is used.
The name of the doctor that prescribed the drugs on the invoice. It should only be specified when the "Prescription Drugs" fee code is used and when the caregiver is a DRG caregiver type (pharmacy).
This field specifies the appliance name that was prescribed by the caregiver. It should only be specified when the "Appliance" fee codes are used.
This field specifies the description of the service provided that was out of Canada. It should only be specified when the "Out of Canada Services - All" fee code is used.
This field specifies the product type (relating to Cannabis) that was prescribed by the caregiver. It should only be specified when the "Cannabis" fee code is used.
This field specifies the ratio (relating to Cannabis) that was prescribed by the caregiver. It should only be specified when the "Cannabis" fee code is used.
This field specifies the tax type (relating to Cannabis) that was prescribed by the caregiver. It should only be specified when the Cannabis tax fee codes is used.
This field specifies the name of the Psychologist. It should only be specified when the "Psychologist" fee codes is used.
The date range complex type
The start date of a date range
The end date of a date range
The billing period complex type. The period during which all services for the invoice were performed.
This is only required when a detail in the treatment describes physiotherapy treatment.
The treatment service date must fall inside this date range.
The billing period is expected to be a standard date range of monthly or bi-weekly, except for certain circumstances.
An example of a non-standard billing period is when one of the primary, secondary, tertiary or mental health care dates
falls within the billing period. For example, if the treatment was performed in the month of June,
the primary care date is June 3, and the billing period is normally monthly,
the billing period can be adjusted from June 1 - June 30 to June 3 - June 30.
The three dates complex type
This is primary care date. This is only required when a detail in the treatment describes therapist treatment.
This field or one of the other 2 care dates are required when a detail in the treatment describes physiotherapy treatment.
This is the secondary care date. This field or one of the other 2 care dates are required when a detail in the treatment describes physiotherapy treatment.
This is the tertiary care date. This field or one of the other 2 care dates are required when a detail in the treatment describes physiotherapy treatment.
This is the mental health date.
The care dates complex type
The documentation complex type
The part of the worker's body that was injured. This is only required when a detail in the treatment describes chiropractor treatment, general practitioner/specialist treatment,
hospital treatment, miscellaneous caregiver treatment, physiotherapy treatment, massage treatment or audiology treatment.
The name of the care provider that referred the patient. Not specifying this field indicates that the patient was not referred by another care provider.
The name of the caregiver that performed the services. This is only required when a detail in the treatment describes hospital treatment.
The period during which all services for the invoice were performed.
This is only required when a detail in the treatment describes treatment.
The treatment service date must fall inside this date range.
The billing period is expected to be a standard date range of monthly or bi-weekly, except for certain circumstances.
An example of a non-standard billing period is when one of the primary, secondary, tertiary or mental health care dates
falls within the billing period. For example, if the treatment was performed in the month of June,
the primary care date is June 3, and the billing period is normally monthly,
the billing period can be adjusted from June 1 - June 30 to June 3 - June 30.
Dates that care was started. This is only required when a detail in the treatment describes physiotherapy treatment.
The person complex type
The person's first name.
The person's last name.
The provincial health number. This is only required if the provincial health number is from Saskatchewan.
The provincial health number complex type
This should be set to true if the provincial health number is from Saskatchewan; false, otherwise.
This must be a valid postal code or zip code.
Postal code or zip code complex type
The address complex type
Address of residence
City of residence
Province or state of residence
This must be a valid province from Canada or state from the United States. The abbreviation definitions can be found on the Canada Post website: http://www.canadapost.ca
Postal code or zip code of residence
Country of residence.
This must be Canada or the United States.
The worker complex type
The worker's name.
The worker's provincial health number information.
The worker's address.
The worker's date of birth.
The date the worker was injured.
The invoice reference complex type
The invoice reference number
The value may be any string that is 30 characters or less.
The treatment complex type
Each invoice that is submitted may have a reference number that is meaningful to the caregiver.
The treatment is performed on an injured worker. This information is not required but it is best to include to reduce errors.
The treatment must include at least one detail that describes what service was performed.
Treatment details must be merged to one invoice, if applicable; they must not be spread out over multiple invoices.
Each treatment must contain documentation details about the service performed. The documentation fields required are dependent on the services provided. As a guideline, a caregiver should provide as much documentation as is available; WCB will ignore extraneous documentation but will not accept invoices where required documentation is missing.
A caregiver may specify comments about the treatment that is relevant when processing the payment.
A comment must be 200 or fewer characters.
The caregiver complex type
For the specified claim, the caregiver provides treatment and this is the description of that treatment.
Each caregiver has a unique number/type combination assigned by WCB or Saskatchewan Health. This is the number portion of that combination.
Each caregiver number must be exactly 6 digits long, right justified, zero-padded, if necessary.
Each caregiver has a unique number/type combination assigned by WCB. This is the type portion of that combination.
Each caregiver type must be exactly 3 characters long. A sample value is "PHY".
Each clinic has a unique number/type combination assigned by WCB. This is the type portion of that combination.
Each clinic type must be exactly 2 characters long. A sample value is "SK".
Each clinic has a unique number/type combination assigned by WCB. This is the number portion of that combination.
Each clinic number must be exactly 4 digits long, right justified, zero-padded, if necessary.
The claim complex type
Each submitted claim must have at least one caregiver providing service. Each caregiver element corresponds to one invoice.
So, if the batch submission contains a claim element with three caregiver elements nested inside of it, three invoices will be generated. Invoices are processed independently.
If one invoice is rejected from processing due to an error, other invoices in a batch may still be accepted for processing.
WCB creates claim numbers for each injury, one patient can have multiple claims with WCB for different injuries. If you were given or know the claim number, please include it with your invoice to streamline payment.
Each claim number must be exactly 8 digits long, right justified, zero-padded, if necessary.
The root element complex type
This is the name of the software vendor.
Each batch must contain at least one claim.
Each batch must have a number which is unique with respect to the caregiver and the sequence of batch submissions; a caregiver may not submit 2 batches with the same number.
The only exception to this rule is when a batch submission is not fully processed due to an internal error or invalid data in the submission.
In that case, the caregiver is notified of the error, the appropriate corrections are made, and resubmission can occur with the same number.
Each batch number must be 20 characters or less.