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    Jenni Bertels   
503-947-7742   

Electronic Data Interchange (EDI)



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EDI Medical Bill Reporting:
 
  Send us an email about EDI Medical Bill Reporting questions
     
  Medical EDI Traffic Report
 
  To obtain Expanded List of Valid Revenue Codes (NUBC web page)
  List of insurers and self-insured employers required to report medical bill data (now Bulletin 359)
  List of taxonomy codes that do not require a diagnosis code
 
  Frequently asked questions for EDI medical bill reporting
 
  Rules affecting EDI medical bill reporting - OAR 436-160
       
  Medical Bill Data Element Requirement Table
     
  DN Error Message Table: (PDF) | (Excel)
 
  EDI Medical Billing Trading Partner Profile Form: Trading Partner Profile (Form 4015)
 
  Oregon Data Elements by Source table
 
  Obtain IAIABC EDI Medical Implementation Guide
     
  Release 2 Transition FAQs and Updates
  Transition to ICD-10 Codes (Information)
  Oregon critical access hospitals are not required to report the MS-DRG codes on their inpatient bills. [Most Oregon hospitals are required to report the appropriate MS-DRG codes on their workers' compensation inpatient hospital bills. (4/1/11)]
    The list of required Oregon hospitals can be found in Oregon Administrative Rule 436-009, Appendix A.
 

EDI Proof of Coverage Reporting:
  Division 162 Electronic Data Interchange; Proof of Coverage Rules
  Proof of Coverage Data Element Requirement Table (see 436-162-0310, Appendix A, page 11)
  Oregon EDI Implementation Guide for Proof of Coverage - December, 2010
  Proof of Coverage-Edit matrix
  Trading Partner Agreement, (Filing Guaranty Contracts), Form 4820; for information contact:
      EDI Coordinator: 503-947-7742; E-mail: edinews.wcd@state.or.us
      Oregon Proof of Coverage EDI Insurer Profile Form 4821
  Insurer registration requirements
  Employee Leasing Policy Identification
 

eBilling for Workers' Compensation
  Proposed ebilling rules, companion guide, resources, and more
 

Other resources:
 

HIPAA

 

International Association of Industrial Accident Boards and Commissions (IAIABC)

 

National Council on Compensation Insurance

 

Insurance Services Office



If you have questions about this webpage, please contact Jenni Bertels, 503-947-7742.