FL EDI R3 Training: The next Claims EDI R3 Training Class will be held based on demand. If you would like to attend training in Tallahassee, fax in a future training request form below.
Future Claims EDI
(non-medical) Release 3 Training: (click
here [12K PDF])
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for the employee address when filing the Electronic First Report of Injury or Illness with the Division, and repealed subsection 69L-56.330 Electronic Formats for Reporting the Employee’s 8th Day of Disability and the Claim Administrator’s Knowledge of 8th Day of Disability (a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, 2010, 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 823 pages long.
Claims EDI Trading Partner Paperwork
ALL WORKERS’ COMPENSATION INSURERS ARE REQUIRED TO HAVE ALREADY SUBMITTED THEIR CLAIMS EDI TRADING PARTNER FORMS NOTED ABOVE.
FL Claims EDI R3 Test Process 6/2010 (click here [30K 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. 7-30-12) (click
here [232K PDF])
Claims EDI R3 Event Table Supplement (REV.
8-14-12) (click
here [145K Excel])
FL Claims EDI R3 Element Requirement Table Supplement (REV.
7-30-12) (click
here [699K Excel])
FL Claims EDI R3 Edit Matrix Supplement (REV. 7-30-12)
(click
here [623K 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.
Claims EDI MTC CB PowerPoint Slides (March 2012): Claims EDI MTC CB Webinar 2012
Claims EDI Basic Overview PowerPoint Slides (January 2011): Claims EDI Basic Overview Webinar 2011
Claims EDI MTCs, Codes, FROI 00 & SROI IP PowerPoint Slides (January 2011): MTCs, Codes, FROI 00_SROI IP Overview Webinar 2011
Claims EDI FL EDI Requirement Tables PowerPoint Slides (January 2011): FL EDI Requirement Tables Webinar 2011
FL Claims EDI Release 3 Missing SA Process PowerPoint Slides (October 2010):
DWC FWCI Conference EDI Training PowerPoint Slides (August 2010):
FL Claims EDI Release 3 Training PowerPoint Slides (Tallahassee Training April 2010):
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):
Please submit all Claims EDI 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.
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 Release 3 Vendors: | Contact Name: | Contact Phone Number: | E-Mail Address: |
|---|---|---|---|
| Actec Systems, Inc. | John Lazenby | (770) 916-6308 | jlazenby@actec.net |
| Aon eSolutions | Don Ameche | (213) 630-3204 | don_ameche@aon.com |
| Cambridge Integrated Services | Michelle Gullick | (614) 987-1581 | michelle_gullick@cambridge-na.com |
| CS Stars | Eric Wild | (212)345-5181 | ewild@csstars.com |
| Ebix (formerly Claims Harbor) | Shayne Garner | (614) 344-4554 | shayne.garner@ebix.com |
| Healthtech | Mark Hughes | (913) 764-9347 | mhughes@htedi.com |
| Insurance Services Office (ISO) | Al Faber | (201) 469-2375 | afaber@iso.com |
| JDI Data Corporation | Kevin Smith | (954) 938-9100 | Kevin.Smith@JDiData.com |
| JW Software, Inc. | Tim Cuckow | (330) 995-0584 | tim.cuckow@jwsoftware.com |
| MCO Advantage | Susan Blackburn | (800) 341-5809 x3088 | susanblackburn@pbmcorp.com |
| Mitchell Workers' Compensation Solutions (formerly Ingenix-Roes) | Kyle Devereaux | (858) 368-7593 | Kyle.devereaux@mitchell.com |
| Origami Risk | Jason Franks | (804) 332-0163 | jfranks@origamirisk.com |
| Quality Resource Management | Nita Chisari | (615) 285-1919 | nitac@qrm-inc.com |
| Recordables, Inc. | Paul Kofman | (312) 961-7894 | paul@recordables.com |
| Startech Software | Mike House | 800-963-3062 | mhouse@startechsoftware.com |
| Tropics Software | Nicholas Albon | (888) 925-1234x308 | nalbon@GOTropics.com |
| United Systems and Software, Inc. | Keith M. Fischer | (407) 875-2120 Ext. 104 | Kfischer@ussincorp.com |
