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FL EDI R3 Test Requirements. Rule 69L-56.320, F.A.C. FL R3 Test Requirements. Rule 69L-56.320, F.A.C., addresses the requirements the Claim Administrator must meet to move from Test to Production status. FL R3 Test Requirements.
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FL EDI R3 TestRequirements Rule 69L-56.320, F.A.C.
FL R3 Test Requirements • Rule 69L-56.320,F.A.C., addresses the requirements the Claim Administrator must meet to move from Test to Production status.
FL R3 Test Requirements • However, the Primary and Secondary Implementation Schedules addressed in the current rule are no longer applicable; • Therefore, newTrading partnersmust test all MTC’s.
FL R3 Test Requirements • During the testing period, all DWC Forms required by Rule 69L-3, F.A.C. must continue to be mailed to the Division.
FL R3 Test Requirements • Claim Admin. must achieve acceptance (TA) for the minimum number of filings for each category of EDI filingsspecified in theFL Claims EDI R3 ‘Test Process’ document (on website) prior to being considered for production status.
FL R3 Test Requirements • Claim Admin. will not be authorized to move to production status at different times for separate categories of required test EDI filings (e.g., EDI DWC-1’s, EDI DWC-13’s, etc.). • All specified MTC’s/Filing Types must be approved before Claim Admin can ‘go live’ with R3.
FL R3 Test Requirements • In addition to testing the specified MTC’s/Filing Types, the Trading Partner must also respond to and resolve several different types of TA-FL Reconciliation Errors in the Data Warehouse before requesting authorization for production status.
FL R3 Test Requirements • R3 test files should report the electronic equivalent of the DWC-1 (paper or R1), DWC-12, DWC-13 and DWC-4 being sent to the Division for actual claims.
FL R3 Test Requirements Note:When testing R3 filings for the Electronic First Report of Injury or Illness using actual claims, the trading partner should use cases that were received and processed by DWC after 3/31/2010. All claims/DWC-1’s (paper or R1) entered prior to 3/31/10 have been copied to our test database.
FL R3 Test Requirements • Use real JCN’s from JCN list when sending standalone test SROI filings for actual claims where the DWC-1 (paper or R1) was established in DWC claims system on or before 3/31/10. Do not use Production JCN’s if the claim was established AFTER 3/31/10.
FL R3 Test Requirements • Use the test JCN returned for the test 00/IP (or other EDI DWC-1 equivalent) when sending “standalone” test SROI filings (e.g., SA) • See test filing categories c – f in Test Process document on web).
FL R3 Test Requirements • If you are a new Claim Admin. and are unable to test with actual claims, “mock” electronic filings may instead be created and sent for testing purposes.
FL R3 Test Requirements • Mock filings must still contain valid data and must not be identical to IAIABC or Florida Business Scenarios.
If you send mock test data, you need to be confident of the quality of your live production data. • There is only a 30 day grace period for FROI late filing penalties after going ‘live’, and • Going back to “testing” status is not an option.
If you change Match Data (e.g., SSN, DOI) for an actual claim, you must not send the JCN provided for that claim on your JCN Listing. • New FROI’s (e.g., 00/IP) will not have a JCN.
Note: Only one JCN Listing will be produced after you file your Trading Partner paperwork. • JCN Lists can be generated upon request. • Send email to claims.edi@myfloridacfo.com for revised JCN List.
Seeking Production Approval • When you think you have satisfied all testing requirements, send an email to claims.edi@myfloridacfo.com and request ‘production approval’. • Production approval process is described in the ‘Test Process’ document on the Claims EDI Webpage (and following slides.)
Seeking Production Approval • To determine the status of your testing, from the Test Warehouse Main Menu, click on ‘Report Cards & Statistical Reports’; then select ‘Generate Claims EDI Report Card’ to yield counts and %’s for each category of EDI filings.
Seeking Production Approval • If it appears testing requirements for all categories have been met, email claims.edi@myfloridacfo.com to request production approval.
Seeking Production Approval • Note: Filings that are assigned ‘TA-FL’ will count as accepted transactions, but will appear in a separate column in the Report Card. • They should be added to the ‘TA’ counts when determining if testing requirements have been achieved.
Seeking Production Approval • Although the “FL Claims EDI R3 Test Process” document indicates each category must be evaluated on the basis of one transmission / Division Rec’d Date, you may also request credit for filings submitted over time via multiple transmissions/ Div Received Dates. …
After you get back to the office, ALL Questions, either Business or Technical, should be sent via email to claims.edi@myfloridacfo.com This email address is copied to all members of the EDI team. It is the quickest and most efficient way for us to respond to your concerns.
