| EDI
Medical Bill Reporting: |
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Send
us an email about EDI Medical Bill Reporting questions |
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Medical
EDI Traffic Report |
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Oregon
EDI Medical Bill Reporting Implementation Guide
12/14/10
(Includes ANSI loop, segment, data
element summary, and file naming instructions.) |
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To
obtain Expanded List of Valid
Revenue Codes (NUBC web
page) |
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List
of insurers required to submit medical billing data
(now Bulletin 359) |
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List
of taxonomy codes that do not require a diagnosis code |
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Frequently
asked questions for EDI medical bill reporting |
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Medical
Bill Data Element Requirement Table (OAR
436-160-410 see page 10) |
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EDI
Medical Billing Trading Partner and Transmission (Sender/Receiver)
Profile Forms: |
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IAIABC
Electronic Trading Partner Profile (Application) |
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IAIABC
Electronic Transmission Profile (Sender/Receiver) Profile |
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Oregon
Data Elements by Source table |
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Obtain
IAIABC EDI Medical Implementation Guide |
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Current
Rules affecting EDI medical bill reporting: |
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Division
160 - Electronic Data Interchange Rules |
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Effective
April 1, 2011, most Oregon hospitals are required to report
the appropriate MS-DRG codes on their workers' compensation
inpatient hospital bills. The list of required Oregon hospitals
can be found in Oregon Administrative Rule 436-009, Appendix
A. Oregon critical access hospitals are not required
to report the MS-DRG codes on their inpatient bills. |
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| EDI
Proof of Coverage Reporting: |
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Division
162 Electronic Data Interchange; Proof of Coverage Rules |
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Proof
of Coverage Data Element Requirement Table (see 436-162-0310,
Appendix A, page 11) |
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Oregon
EDI Implementation Guide for Proof of Coverage - December,
2010 |
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Proof
of Coverage-Edit matrix |
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Trading
Partner Agreement, (Filing Guaranty Contracts), Form 4820;
for information contact: |
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EDI
Coordinator: 503-947-7742; E-mail: edinews.wcd@state.or.us |
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Oregon
Proof of Coverage EDI Insurer Profile Form 4821 |
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Insurer
registration requirements |
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Employee
Leasing Policy Identification |
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| Proposed
eBilling for Workers' Compensation |
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Proposed
ebilling rules, companion guide, resources, and more |
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| Other
resources: |
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HIPAA
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International
Association of Industrial Accident Boards and Commissions
(IAIABC)
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National
Council on Compensation Insurance
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Insurance
Services Office
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