EDI Newsletter. EDI/Triage Team : Happy Belated 10 th Birthday to EDI Release- 3 in Florida! April Inside this Issue: Team News 1

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1 EDI Newsletter Inside this Issue: Team News 1 TA-FL Updates... 2 Crossword... 4 FAQs... 5 Training Times... 5 Contact Us... 5 Happy Belated 10 th Birthday to EDI Release- 3 in Florida! EDI/Triage Team : Katina Ferrell has left the EDI team to pursue new opportunities. Her hard work, and dedication to you, our partners, made her an important and integral part of the team. We wish her tremendous success in her future endeavors. If you were working with Katina, please do not her personal . Instead, us directly at: Claims.edi@myfloridacfo.com so that our team may better assist you! 1

2 TA- FL CHANGES COMING TO YOU! These edits were previously mentioned in an sent from the Division on 10/04/2017. This is a reminder that the adjustments are going into effect next month. Again, these errors will reject on submitted transactions as of May 1, 2018 rather than accept with errors (TA-FL). Please be aware of these changes prior to submitting any new transactions to avoid potential errors. Effective May 1, 2018, the errors listed below will no longer receive TA-FL error notifications. Hurray! You will no longer receive the following TA-FL errors: Employee Date of Birth does not match DOB on file (on MTC AQ) ) For DOI's 8/1/79 through 4/30/82, DT Benefit Type Amount Paid must not be greater than $50,000 2) For DOI's 5/1/82 through 9/30/2003, DT Benefit Type Amount Paid must not be greater than $100,000 3) For DOI's 10/1/2003 to present, DT Benefit Type Amount Paid must not be greater than $150, Benefit Type Amount Paid > maximum parameter Benefit Type Amount Paid < minimum parameter Date of Death is greater than 5 years from Date of Injury but Death Benefits Funeral paid Credit Amount must not be greater than 20% of Gross Weekly Amount (For Benefit Credit Code C - Overpayment Credit) OBT Amount is > maximum parameter OBT Amount is < minimum parameter Payment Amount > maximum parameter Transactions that contain these scenarios, will now receive a TA. To clean up any open TA-FL s we will be running a mass closure of TA-FL s on this list that are still open, shortly after May 1. 2

3 There will be a few TA-FL s that will be changing to a TR after May 1, Employee Age cannot be < 13 years old or > 85 years old Benefit Amount Paid is less than $5 of FL calculated Net Weekly Amount x Benefit Weeks/Days for suspension transactions for the following benefits; BTC = 010, 050, 051, and 410 and no BTC 020/021 is present Average Wage was reported as < $20 per week TA-FL Notifications that will remain TA-FL s. Now that you know which TA-FL s are changing to TA s and TR s, there are still some that will continue to be TA-FL notifications. These are the ones that you will continue to receive a TA-FL on and the process for closing these will remain the same. Overpayment Notifications (for informational purposes only) Date of Death prior to end date for non-fatal benefits Weeks reported over max. suspected overpayment PT Notifications Benefit Type Amount Paid for PT/PTS is greater than the max parameter Benefit Type Amount paid for 020 or 021 is less than previously reported OBT Amount for OBT Code can t be less than amount previously reported TA-FL errors remaining as TA-FL errors Benefit Amount Paid not within $5 over under calc for Benefit Amount Paid for BTC Send Missing Data on FROI 02 if not of FROI 04 3

4 EDI Crossword Across: 3. Other Benefit Type Code for Total Unallocated Prior Paid Indemnity Benefits 7. RTW Type Code R 9. Full Denial Code 5C 10.Accident Premises Code L Down 1. Late Reason Code L1 2. An indication of which flat file the data element resides in a subsequent report 4. Subsequent Report for a Volunteer 5. The I stands for what in Claim Type I 6. TA-FL is accepted with 8. Death Result of Injury Code U 4

5 FAQ s: Q: Our first report rejected due to the DAN. A: Please be sure when requesting a DAN, the name and other information being sent in the request is the same as it will be when reported on your first report. Be sure to report Employee ID Type A for Division Assigned Number, rather than S for Social Security Number. Additionally, DAN s are designed to be temporary. If a transaction is not filed with the Division reporting the DAN (either Medical or Claims EDI) within 6 months, the DAN will be deleted from our internal system. Q: We received a fine that we do not believe we should have received. A: Please contact your designated CPS Liaison. If you do not know who is your CPS Liaison, please ss medfor mat@ myfloridacfo. c om. News: Margaret and Victoria traveled to the Fort Lauderdale area this past month! They had the opportunity to meet with 5 different Trading Partners and their associates on this trip. Each session was interactive and informative. If you were one of the partners we met with, it was wonderful meeting with you face to face! If you would like register for training, please contact us, the Triage Claims EDI Team at: Triage Claim s. edi@myfloridacfo. com We Appreciate Your Feedback! EDI is tricky, but we are here to help in any way that we can. How can we better assist you? What topics would you like to see in future issues? You can reach the EDI team by ing us at: clai ms. edi@ myfloridacfo.co m 5