Florida Regulations 69L-56.307: Electronic Cancellation of Claim
Current as of: 2024 | Check for updates
|
Other versions
(FROI MTC 01 as found in the IAIABC Implementation Guide for Claims: First, Subsequent, Header, Trailer and Acknowledgement Detail Records, Release 3, January 1, 2009 Edition.)
(1) The claim administrator shall send FROI MTC 01 (Cancel) immediately upon the claim administrator’s knowledge of the need to cancel if any of the following occur:
(a) An Electronic First Report of Injury or Illness was accepted by the Division and the claim administrator subsequently determined the claim was filed in error because it was actually a Medical Only Case. The FROI MTC 01 shall reflect the Claim Type as “”B”” (Became Medical Only).
(b) An Electronic First Report of Injury or Illness was accepted by the Division and the claim administrator subsequently determined the claim was filed with inaccurate identifying information and was a duplicate of another accepted claim.
(2) If a claim has been cancelled via FROI MTC 01 (Cancel) after an Electronic First Report of Injury or Illness was previously filed with the Division and the claim administrator determines the claim should not be cancelled after all, the claim administrator shall re-file a subsequent Electronic First Report of Injury or Illness using the applicable MTC(s) specified in this rule for reporting an Electronic First Report of Injury or Illness. The original Electronic First Report of Injury or Illness sent to the Division shall be disregarded and considered not filed with the Division. The due date for filing the subsequent Electronic First Report of Injury or Illness shall correspond to the filing timeframes specified in this rule for the applicable MTC(s) required for an Electronic First Report of Injury. If un-canceling a claim to file a full or partial denial of indemnity benefits, the claim administrator shall provide to the employee and employer, Form DFS-F2-DWC-12 adopted in Rules 69L-56.4012 and 69L-3.025, F.A.C.
Rulemaking Authority 440.591, 440.593(5) FS. Law Implemented Florida Statutes § 440.593. History-New 1-7-07, Amended 5-17-09.
(a) An Electronic First Report of Injury or Illness was accepted by the Division and the claim administrator subsequently determined the claim was filed in error because it was actually a Medical Only Case. The FROI MTC 01 shall reflect the Claim Type as “”B”” (Became Medical Only).
(b) An Electronic First Report of Injury or Illness was accepted by the Division and the claim administrator subsequently determined the claim was filed with inaccurate identifying information and was a duplicate of another accepted claim.
(2) If a claim has been cancelled via FROI MTC 01 (Cancel) after an Electronic First Report of Injury or Illness was previously filed with the Division and the claim administrator determines the claim should not be cancelled after all, the claim administrator shall re-file a subsequent Electronic First Report of Injury or Illness using the applicable MTC(s) specified in this rule for reporting an Electronic First Report of Injury or Illness. The original Electronic First Report of Injury or Illness sent to the Division shall be disregarded and considered not filed with the Division. The due date for filing the subsequent Electronic First Report of Injury or Illness shall correspond to the filing timeframes specified in this rule for the applicable MTC(s) required for an Electronic First Report of Injury. If un-canceling a claim to file a full or partial denial of indemnity benefits, the claim administrator shall provide to the employee and employer, Form DFS-F2-DWC-12 adopted in Rules 69L-56.4012 and 69L-3.025, F.A.C.
Rulemaking Authority 440.591, 440.593(5) FS. Law Implemented Florida Statutes § 440.593. History-New 1-7-07, Amended 5-17-09.