Division of Workers' Compensation
Claims EDI (non-medical)
CLAIMS EDI RELEASE 3 (updated 9-11-09)
FL EDI R3 Training: The Florida Division of Workers’ Compensation announces a free two day EDI training class October 6, 7, and 8, 2009 in Tallahassee on the Claims EDI Release 3 mandate, and EDI Rule (69L-56, F.A.C.). Seating is limited to 75, and prior registration is required. Registration preference will be given to those who have previously submitted a request for future training and those who have not previously attended an EDI training class. Please complete and return the EDI Training Registration form to the Division.
Click here to register
Rule 69L-56, F.A.C., as amended January 7, 2007, required the electronic submission of Claims (non-medical) filings (in addition to the already required electronic submission of POC data). 69L-56, F.A.C., was revised effective May 17, 2009 to specify insurer requirements for reporting proof of coverage information to the Division to identify a professional employer organization or employee leasing company and its client companies. Additionally, the rule incorporated by reference revised national standard EDI implementation guides for POC (Release 2.1) and Claims (Release 3); updated the Florida POC Implementation Manual containing a new requirement to report Total Payroll and Number of Employees, as well as an updated Florida POC Implementation Manual containing a new requirement to report total payroll and number of employees. The rule also adds a new definition for the meaning of “Cancellation/Non-Renewal Effective Date”. The rule also clarified that the employer address must not to be substituted for the employee address when filing the Electronic First Report of Injury or Illness with the Division, and repealed subsection 69L-56.330 Electronic Formats for Reporting the Employee’s 8th Day of Disability and the Claim Administrator’s Knowledge of 8th Day of Disability (a Release 1 Claims EDI filing requirement). Revised EDI forms adopted in conjunction with the revisions to the rule are posted below. All insurers and claim administrators handling Florida claims should download and review the requirements of Rule 69L-56, F.A.C. (click here [257K PDF]).
The IAIABC EDI Implementation Guide for Claims: First, Subsequent, Header, Trailer & Acknowledgement Detail Records, Release 3, January 1, 2008, can be ordered from the IAIABC's web site at http://www.iaiabc.org/i4a/pages/index.cfm?pageid=3347 . The IAIABC now charges $95 for the R3 Guide if your company is not an IAIABC EDI member. The IAIABC's website also contains other important code tables required for Release 3 filings. It is recommended that insurers/claim administrators order this Guide and begin reviewing it with management and IT staff. If you choose to print the Guide, please be advised that it is set up to print double-sided and is 835 pages long.
FL Claims EDI Implementation Manual (click here [124K PDF]): The Florida Division of Workers’ Compensation Claims Electronic Data Interchange (EDI) R3 Implementation Manual, September 2006, is incorporated by reference in Rule 69L-56, F.A.C., and contains the electronic filing specifications for sending claims data to the Division. The manual contains the trading partner forms that are required to be filed with the Division prior to testing, as well as the Event Table, Element Requirement Table, and Edit Matrix. IMPORTANT: Do not print the “Event Table”, “Element Requirement Table” and the “Edit Matrix” contained in the FL Claims EDI Implementation Manual; instead print the revised tables contained in the Supplement, below.
ALL WORKERS’ COMPENSATION INSURERS ARE REQUIRED TO HAVE ALREADY SUBMITTED THEIR CLAIMS EDI TRADING PARTNER FORMS NOTED ABOVE.
INSURERS THAT WERE GRANTED EXTENSIONS TO TIER 4 SHOULD BE SUBMITTING TEST FILES AT THIS TIME.
FL EDI R3 TESTING
FL Claims EDI R3 Test Process 1/2008 (click here [38K PDF])
Please send any questions or report any R3 testing errors you do not understand or feel you received in error to claims.edi@myfloridacfo.com. Include the claim number or JCN associated with the filing, and the specific error message (error number) received. Emails sent to this address will be delivered to all members of the EDI team and will be responded to in a timelier manner than will emails or voice mails directed to an individual EDI team member. Errors and questions reported to claims.edi@myfloridacfo.com will be researched daily and responded to/corrected as quickly as possible.
FL Claims EDI Supplement: The Supplement provides an overview of changes/corrections to the Event Table, Element Requirement Table, and/or Edit Matrix, that were made after the date the previous version of the rule was posted to the Division’s web site (for the Notice of Proposed Rulemaking). The Supplement also contains the updated tables, which reflect the last revision date and color-coded changes as tan-shaded cells with blue text.
 Supplement - Overview (REV. 9-11-09) (click here [857K Word])
Claims EDI R3 Event Table Supplement (REV. 9-11-09) (click here [108K Excel])
FL Claims EDI R3 Element Requirement Table Supplement (REV. 9-1109) (click here [610K Excel])
FL Claims EDI R3 Edit Matrix Supplement (REV. 9-11-09) (click here [520K Excel])
Florida R3 Claims EDI Migration Strategies (click here [39K PDF] REV. 2-27-08) The Florida R3 Claims EDI Migration Strategies document addresses how a claim administrator should transition from paper or EDI R1 electronic filings, to R3. This document also discusses how to obtain the Jurisdiction Claim Number (JCN), a data element that will be required on all subsequent electronic filings sent after the First Report of Injury or Illness.
Helpful FL EDI R3 Resources: The following resource documents should be reviewed by the claim administrator to assist in implementing the Claims EDI R3 filing requirements. Note: Please continue to check for the posting of additional scenarios/revisions.
 DWC FWCI Conference EDI Training PowerPoint Slides (August 2009):
FL Claims EDI Release 3 Business Training PowerPoint Slides (Tampa Training August 2008):
FL Claims EDI Release 3 Business Training PowerPoint Slides (Tallahassee Training Feb 2008):
FL Claims EDI Release 3 Business Training PowerPoint Slides (Technical Slides Feb 2008):
Florida DWC Claims Electronic Data Interchange (EDI) Release 3 Vendor Listing:
The following list comprises a link to known vendors offering a Claims EDI Release 3 related product and/or service for submitting claims data electronically to the Florida Division of Workers’ Compensation. This listing will be updated as more vendors become known.
This listing is in alphabetical order and does not represent an endorsement by the Department of Financial Services, Division of Workers’ Compensation of any vendor listed, or a recommendation of one vendor over another. The Department does not warrant or represent that this information is current, complete and accurate. The Department assumes no responsibility for any errors in the information provided, nor assumes any liability for any damages incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this Web site, and shall be held harmless against all claims, suits, judgments and/or damages resulting from the disclosure of any of this information, including all costs and fees.
NOTE: If you are a vendor and would like to have your company added or removed, please contact claims.edi@myfloridacfo.com.
Claims EDI Contacts:
During implementation of Claims EDI R3, we ask that you submit all questions/problems to claims.edi@myfloridacfo.com. This email address will reach all members of the EDI team, and our Technical contact, and will enable us to provide you with the best customer service.
Claims EDI Databases:
Paper vs. Electronic Submission Statistics, Claims Related Incoming Documents:
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