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Division of Worker's Compensation
633 17th Street
Denver, Colorado 80202

EDI IMPLEMENTATION

                                          
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bullet EDI Home
bullet EDI Overview
bullet Getting Started
bullet First Report of Injury   (FROI)
Electronic Data Interchange Participation Policy
Receiver's (DOWC) Trading Partner Profile
Receiver's (DOWC) Transmission Partner Profile
Data Element Matrix
Edit Matrix
Edit/Error message Matrix (NEW!)
Event Table 
Testing Requirements

 
bullet EDI Participation Documents (All fillable forms)
EDI Sender Acceptance Form
Sender Trading Partner Profile
Sender Transmission Profile
Trading Partner Insurer List Form
Third Party Administrator Location List Form  (If a TPA is the Sender)

 
bullet

Subsequent Report of Injury  (SROI)Receiver's (DOWC) Trading Partner Profile
Receiver's (DOWC) Transmission Profile

              Testing Requirements

DENIAL (MTC 04)
Data Element Matrix
Edit Matrix
Edit/Error Message Matrix
Event Table

FINAL PAYMENT NOTICE (MTC FN)
Data Element Matrix
Edit Matrix
Edit/Error Message Matrix
Event Table

PPD Part of Body Codes

bullet Proof of Coverage
Rule 3

Medical/Bill Payment Records
are presently unavailable.
 
bullet IAIABC Web Site

 

 

 

First Report of Injury

To participate in the Colorado’s EDI program for First Report of Injury, you will need the following documents: 

Once you have gathered all of the information for the Colorado’s EDI program, you will need to complete the following documents and return them to DOWC:

  • EDI Sender's Acceptance Form
  • Sender's Trading Partner Profile
  • Sender's Transmission Profile
  • Trading Partner Insurer List Form
  • Third Party Administrator Location
    List Form (If a TPA is the Sender)
pdf or MS Word
pdf or MS Word
pdf or MS Word
pdf or MS Word
pdf or MS Word