Florida providers must use Form DFS-F5-DWC-25 for treatment authorization requests.
When to Use Form DFS-F5-DWC-25
Providers must complete and submit the Florida Workers’ Compensation Uniform Medical Treatment/Status Reporting Form (DFS-F5-DWC-25) to request authorization before treating injured workers, except in emergencies.
To request treatment authorization, providers must do the following:
- Complete the DFS-F5-DWC-25 Form: Clearly indicate the treatment plan, referral, or medical service requested.
- Submit the form directly to the claims administrator: Do not route the request through the employer or the injured employee.
- Keep proof of submission: Save a fax confirmation, email receipt, or electronic receipt to document the date sent.
- Track the response deadline: The claims administrator must respond within 3 business days by phone or in writing.
Note: The treatment is automatically authorized if the claims administrator does not respond within 3 business days.
Florida |
Statute/Rule |
Statute |
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Section |
440.20 Time for Payment of Compensation and Medical Bills; Penalties for Late Payment |
Subsection Text |
440.20 (2) (a) As a condition to eligibility for payment under this chapter, a health care provider who renders services must receive authorization from the carrier before providing treatment. This paragraph does not apply to emergency care.
440.20 (2) (d) A carrier must respond, by telephone or in writing, to a request for authorization from an authorized health care provider by the close of the third business day after receipt of the request. A carrier who fails to respond to a written request for authorization for referral for medical treatment by the close of the third business day after receipt of the request consents to the medical necessity for such treatment. All such requests must be made to the carrier. Notice to the carrier does not include notice to the employer.
440.20 (2) (e) Carriers shall adopt procedures for receiving, reviewing, documenting, and responding to requests for authorization.
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