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EDI medical bill data reporting is used to standardize the manner in which insurers and trading partners report workers’ compensation medical bill and payment data to various jurisdictions. EDI medical bill data includes the same criteria required on the paper claim form. Oregon uses the IAIABC EDI Medical Bill Data Reporting Release 2.0 standard.
Insurers with an average of at least 100 accepted disabling claims per year, based on the average accepted disabling claim volume for the previous three calendar years, are required to submit medical bill data electronically.
List of insurers and self-insured employers currently required to reportEDI medical frequently asked questions
Jenni Bertels: 503-947-7742
Receive updates to EDI information
International Association of Industrial Accident Boards and Commissions (IAIABC)
eBilling Rules (Division 008)
EDI Medical Bill Data Rules (Division 160)
EDI Proof of Coverage Rules (Division 162)
Oregon Medical Fee and Payment Rules
The Accredited Standards Committee (ASC) X12
National Council for Prescription Drug Programs (NCPDP)
National Uniform Billing Committee (NUBC)
National Uniform Claim Committee (NUCC)
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