Certification as a Health Care Provider
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According to s. 440.13(1) (d), Florida Statutes (F.S.), a “certified health care provider” is a provider approved to receive reimbursement through the FL WC System. A certified provider may be a physician, a licensed practitioner or a facility approved by the Division or a provider who has entered an agreement with a licensed managed care organization to provide treatment to injured employees.
A health care provider interested in rendering medical treatment and care to an injured employee must be certified pursuant to Rule 69L-29.002, F.A.C. by the Division or deemed certified, pursuant to s. 440.13(1)(d), F.S., as a provider within a managed care organization licensed through the Agency for Health Care Administration (AHCA). Certification of a provider includes documentation that the provider has read and is familiar with the portions of the statute, impairment guides, standards of care, protocols of treatment, and rules that govern the provision of remedial treatment, care, and attendance.
The Certification Process
The HCP certification process includes the completion and submission of the HCP Certification Form DFS-3160-0020 to the Division accompanied by proof of possession of a valid license issued by the State of Florida Department of Health (DOH) or AHCA.
The following health care providers are deemed certified and are not required to submit a completed HCP Certification Form DFS-3160-0020 to the Division. These providers may receive reimbursement as deemed certified health care providers:
- Hospitals licensed through AHCA under Chapter 395;
- Nursing Homes licensed through AHCA under chapter 400;
- Home Health Agency licensed through AHCA under Chapter 400;
- Home Health Medical Supplier/Durable Medical Equipment Provider licensed through AHCA under Chapter 400; or
- Any physician, recognized practitioner or facility under contract with a managed care organization licensed through AHCA.
A provider remains certified unless the provider elects to have his/her name removed from the Division’s Provider Database or the Division enters an adverse action against the provider for violation(s) of Chapter 440, F.S.
Updating the Division’s Provider Database
Health care providers shall notify the Department in writing of any change in the status of that health care provider’s license, or mailing address within 10 days of such change. Such changes shall be sent to: Division of Workers’ Compensation, Office of Medical Services, c/o Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232.
Frequently Asked Questions
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