69L-56.001. Forms and Instructions

The following forms are incorporated herein by reference and adopted for use in filing Proof of Coverage (POC) and Claims (non-medical) Electronic Data Interchange (EDI) transactions to the Division. All of the forms may be obtained from the Division of Workers’ Compensation at its website, http://www.myfloridacfo.com/Division/WC/EDI/Clms_EDI.htm. (1) DFS-F5-DWC-EDI-1, “EDI Trading Partner Profile” (1/01/2008). (2) DFS-F5-DWC-EDI-2, “EDI Trading Partner Insurer/Claim Administrator ID List” (10/01/2006). (3) DFS-F5-DWC-EDI-2A, “EDI Trading Partner Claim Administrator Address List” (10/01/2006). (4) DFS-F5-DWC-EDI-3, “EDI Transmission Profile-Sender’s Specifications” (10/01/2006). (5) DFS-F5-DWC-EDI-4, “Secure Socket Layer (SSL)/File Transfer Protocol (FTP) Instructions” (1/01/2008).