Florida Regulations 69L-56.001: Forms and Instructions
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The following forms are incorporated herein by reference and adopted for use in filing Proof of Coverage (POC) and Claims (non-medical) Electronic Data Interchange (EDI) transactions to the Division. All of the forms may be obtained from the Division of Workers’ Compensation at its website, http://www.myfloridacfo.com/Division/WC/EDI/Clms_EDI.htm.
(1) DFS-F5-DWC-EDI-1, “”EDI Trading Partner Profile”” (1/01/2008).
(2) DFS-F5-DWC-EDI-2, “”EDI Trading Partner Insurer/Claim Administrator ID List”” (10/01/2006).
(3) DFS-F5-DWC-EDI-2A, “”EDI Trading Partner Claim Administrator Address List”” (10/01/2006).
(4) DFS-F5-DWC-EDI-3, “”EDI Transmission Profile-Sender’s Specifications”” (10/01/2006).
(5) DFS-F5-DWC-EDI-4, “”Secure Socket Layer (SSL)/File Transfer Protocol (FTP) Instructions”” (1/01/2008).
Rulemaking Authority 440.591, 440.593(5) FS. Law Implemented Florida Statutes § 440.593. History-New 3-5-02, Formerly 38F-56.001, 4L-56.001, Amended 5-29-05, 1-7-07, 5-17-09.
(2) DFS-F5-DWC-EDI-2, “”EDI Trading Partner Insurer/Claim Administrator ID List”” (10/01/2006).
(3) DFS-F5-DWC-EDI-2A, “”EDI Trading Partner Claim Administrator Address List”” (10/01/2006).
(4) DFS-F5-DWC-EDI-3, “”EDI Transmission Profile-Sender’s Specifications”” (10/01/2006).
(5) DFS-F5-DWC-EDI-4, “”Secure Socket Layer (SSL)/File Transfer Protocol (FTP) Instructions”” (1/01/2008).
Rulemaking Authority 440.591, 440.593(5) FS. Law Implemented Florida Statutes § 440.593. History-New 3-5-02, Formerly 38F-56.001, 4L-56.001, Amended 5-29-05, 1-7-07, 5-17-09.