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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DFS-F6-DWC-3160-0023
for the current year.
Form DFS-F6-DWC-3160-0023 Petition for Resolution of Reimbursement Dispute - Florida
What Is Form DFS-F6-DWC-3160-0023?
This is a legal form that was released by the Florida Department of Financial Services - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form DFS-F6-DWC-3160-0023?A: Form DFS-F6-DWC-3160-0023 is the Petition for Resolution of Reimbursement Dispute specific to the state of Florida.
Q: What is the purpose of this form?A: The purpose of this form is to request resolution of a reimbursement dispute.
Q: Who can file this form?A: This form can be filed by a healthcare provider or a carrier (insurer or self-insured employer).
Q: What should be included in the form?A: The form should include details of the dispute, supporting documents, and any additional information requested.
Q: Is there a fee for filing this form?A: Yes, there is a fee for filing this form. The fee amount may vary.
Q: Is legal representation required to file this form?A: Legal representation is not required, but it may be beneficial to consult with an attorney familiar with workers' compensation laws in Florida.
Form Details:
- Released on March 1, 2017;
- The latest edition provided by the Florida Department of Financial Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form DFS-F6-DWC-3160-0023 by clicking the link below or browse more documents and templates provided by the Florida Department of Financial Services.
Download Form DFS-F6-DWC-3160-0023 Petition for Resolution of Reimbursement Dispute - Florida
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