<CDLE Home>
<State Homepage>
<DOWC Home>

Division of Worker's Compensation
1515 Arapahoe
Denver, Colorado 80202

EDI IMPLEMENTATION

                                          
A note on file formats:
Some documents on this site are in PDF format and require a one time download of Adobe Acrobat Reader to view and print them.  You can download the Acrobat Reader free of charge from the Adobe® web site, configure your browser according to the instructions provided, then use your browser's "back" button to return to this page.

 

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
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)

DENIAL (MTC 04)
Receiver's (DOWC) Trading Partner Profile
Receiver's (DOWC) Transmission Profile
Data Element Matrix
Edit Matrix
Edit/Error Message Matrix
Event Table
Testing Requirements

FINAL PAYMENT NOTICE (MTC FN)
Data Element Matrix
Edit Matrix
Edit/Error Message Matrix
Event Table
 
bullet Proof of Coverage
Rule III

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 and decided to participate in 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