Division of Workers' Compensation

Medical EDI

Medical EDI Contacts:

• Theresa Pugh, Systems Project Admin, (850) 413-1721, theresa.pugh@myfloridacfo.com
• Mark Harrell, Medical EDI Contact, (850) 413-1734, mark.harrell@myfloridacfo.com
• Karen Chi, Medical EDI Contact, (850) 413-1710, karen.chi@myfloridacfo.com
• Pi-Ching Huang, Medical EDI Technical Contact, (850) 413-1758, pi-ching.huang@myfloridacfo.com

Medical Implementation Manuals (PDF's):

• Florida Medical EDI Implementation Guide (MEIG), 2010, Effective July 8, 2010
• Florida Medical EDI Implementation Guide (MEIG), 2007, Effective March 8, 2007
• Instruction Manual for the Online Medical Data Management System (MDMS), 2010, Updated 4/15/2011
• Instruction Manual for the Online Medical Data Management System (MDMS), 2007, Updated 5/14/2010
• The Medical Data Management System (MDMS) web site was developed to assist small insurers with a low volume of workers' compensation medical bills to comply with the mandate for electronic submission of the DFS-F5-DWC-9, DFS-F5-DWC-10, DFS-F5-DWC-11, and DFS-F5-DWC-90 medical bills (no more than 200 per month including all four form types). The Instruction Manual for the Online Medical Data Management System (MDMS), 2010 provides a step-by-step guide to navigating the system and entering data correctly into each data field. For information on setting up an MDMS web account, contact the medical EDI team at MedicalDataManagementTeam@myfloridacfo.com

Medical EDI Forms and Informational Documents (PDF's) for Revision E:

• Duplicate Claim Check Program Logic
• DWC-9, DWC-10, and DWC-11 EDI Business Rules - Updated 5/26/2011
• DWC-90 EDI Business Rules for Ambulatory Surgical Centers - Updated 5/26/2011
• DWC-90 EDI Business Rules for Home Health Agencies - Updated 5/26/2011
• DWC-90 EDI Business Rules for Inpatient Hospitals - Updated 5/26/2011
• DWC-90 EDI Business Rules for Nursing Homes - Updated 5/26/2011
• DWC-90 EDI Business Rules for Outpatient Hospitals - Updated 5/26/2011
• DWC-90 Facility Bill Types not reported for Revision E - Updated 9/16/2010
• Employee Reimbursement Bills
• EOBR by Form Restrictions - Updated 5/26/2011
• MDMS Web Site FAQ - Updated 9/26/2011
• Edits on Total Paid Amounts by Form Type
• Edits on Total Charged Amounts by Form Type - Updated 10/11/2010
• Reconsideration Scenarios
• Revenue Code Programming Document for Ambulatory Surgical Center Bills - Updated 9/16/2010
• Revenue Code Programming Document for Home Health Agency Bills - Updated 9/16/2010
• Revenue Code Programming Document for Outpatient Nursing Home Bills - Updated 1/13/2011
• Revenue Code Programming Document for Outpatient Hospital Bills - Updated 9/16/2010
• SSL/FTP Transfer Instructions
• SSL/FTP Troubleshooting Guide
• Submitter SSL/FTP Instructions for WSFTP Pro 9.0
• Valid License Prefixes - Updated 3/4/2011

 

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