VWC requires each entity, including those who plan to use a service provider, to complete the Electronic Transmission Profile. The Transmission Profile provides pertinent information about the receiver, sender and transmission protocol. The Transmission Profile is a two part document.
The first part of the Electronic Transmission Profile contains the VWC’s information. This part of the form contains information needed in order to address and forward your electronic transmissions to the Virginia Workers’ Compensation Commission.
The second part of the document contains information pertaining to the sender’s electronic transmission profile. This document indicates how the trading partner will send data to the VWC. If a claim administrator is sending data for more than one location, then a separate sender’s profile is required for each location.
This document must be fully completed in order for your organization to be approved for production in Virginia. All of the Receiver Information (VWC) has been provided for you.
Page 1 – The page has been completed for you with the VWC’s information and our requirements for submitting.
Page 2 – Please complete the following sections:
- Legal Name: Please provide the legal name of the entity submitting the EDI Transactions to VA.
- Sender ID: Please provide the Federal Employer Identification Number (FEIN) and Postal Code of the entity listed above (Legal Name).
- Transmission Frequency: Please select the transmission frequency that will apply to your organization.
- Selected Media: Should be Secure FTP.
- Electronic Mailbox for this Profile: This should remain blank since it applies to the Selected Media type of Network.
- Secure File Transfer Protocol (SFTP) for this Profile: This should remain blank. Once you are approved for production in Virginia, the Commission or its EDI vendor will provide you with the SFTP information for your daily EDI submissions.
This form may be filed with the Commission in the following ways:
- EMAIL: Email the completed forms to firstname.lastname@example.org. Please add “Trading Partner Documents” as the subject.
- FAX: Fax the complete form to 804-418-4919 with Attention: EDI QA Department
- MAIL: Mail the completed form to 333 E. Franklin St., Richmond, VA 23219 with Attention: EDI QA Department
For questions, please contact the Commission toll-free at 1-877-664-2566 and ask for the EDI QA Department or by email at email@example.com.