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PWK -- Submitting your claim documentation electronically

How can PWK help you?
PWK is an easy and proactive option for you to submit documentation with your initial electronic claim when you're certain medical records will be requested.
PWK (Paperwork) is a segment within the 2300/2400 loop of the X12N version 5010 837 Professional and Institutional electronic transactions. PWK allows you to indicate on a Part A or Part B electronic claim that you’re submitting additional documentation via mail or fax (PWK 02 segment, BM [by mail] and FX [by fax] qualifier).
If you know your service will typically result in an additional documentation request (ADR) from us, PWK can help you be proactive and submit the documentation along with your claim.
Where to Start
Get started
more Learn how to electronically submit your claims, medical records, and other correspondence.
Avoid the wait, submit electonicically.
Complete the PWK fax/mail/esMD coversheet
Complete the appropriate coversheet electronically, prior to printing. This will assist in ensuring legibility and processing.
Note: Only one coversheet will be accepted for each submitted claim.
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Fax or mail PWK coversheet with documentation to First Coast
Only submit documentation for one patient per coversheet.
Include all supporting documentation.
If any part of documentation is missing (or received past allotted timeframe), submitted documentation will not be used for claim processing.
If documentation is needed, we will suspend the electronic claim and request all supporting documentation through the normal ADR process, regardless if partial information was previously submitted using PWK.
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PWK Resources
Take advantage of these helpful resources and reference guides to help you bill better and prevent PWK or claim issues.
5010 Companion Guides
Information on the PWK segment is available in the X12 Version 5010 837I and 837P Companion Guides.
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Additional resources
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First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.