Use the resources on this page to correctly register, test and exchange EDI information with DMAP.
Receive EDI updates by e-mail or view the most recent changes.
To register as an Oregon Medicaid trading partner, complete the EDI Registration Packet (DMAP 2080, 2081 and 2082, described below).
- Oregon Medicaid requires the original signature of the Trading Partner or Authorized Signer on all forms. We will not accept forms with a stamped signature or forms sent as electronic copies (i.e., faxes or e-mailed copies).
- Learn more in How to complete the EDI Registration Packet.
|DMAP 2080 (Packet Pages 1-5)|
All Trading Partners must sign a TPA in order to do business electronically with Oregon Medicaid. If your trading partner name, Tax ID and/or Oregon Medicaid provider number changes, you will need to submit a new TPA.
|DMAP 2081 (Packet Pages 6-8)|
Exhibit A of the TPA gives Oregon Medicaid information on who will be submitting your electronic transactions.
|DMAP 2082 (Packet Pages 9-10)|
Exhibit B of the TPA tells Oregon Medicaid which electronic transactions that you or your electronic submitters want to register for.
Use Exhibit C to update contact information listed on Exhibit A and add or delete your registered transaction on Exhibit B.
To register as an Oregon Medicaid trading partner, complete all three forms in this packet (DMAP 2080, 2081 and 2082).
As Oregon MMIS Technical Specifications are approved by ASC X12, they will be posted here. If you require a guide that is not currently listed, contact EDI Support Services at DHS.EDISupport@state.or.us.
The following documents are currently are being revised for X12 review. CCOs/plans: Please contact your Encounter Data Liaison if you need a copy of these documents.
- 834 Supplement - HD04 Element Definitions
- 834 - Daily Enrollment
- 834 - Monthly Enrollment
Click "Topic" to filter by resource type or "Document Type" to filter/select by format. You can also type in the "Search" box to search on any field below (for example, type "834" to view all 834-related documents).
|270 - Eligibility Inquiry||OR-MMIS Technical Specifications||X12 Approved|
|271 - Eligibility Response||OR-MMIS Technical Specifications||X12 Approved|
|271 Supplement - Carrier Code List||Eligibility verification, OR-MMIS Technical Specifications||Quick reference|
|271 Supplement - EB Values||OR-MMIS Technical Specifications||Quick reference|
|271 Supplement - EB05 Benefit Descriptions||Eligibility verification, OR-MMIS Technical Specifications||Quick reference|
|276 - Claim Status Inquiry||OR-MMIS Technical Specifications||X12 Approved|
|277 - Claim Status Response||OR-MMIS Technical Specifications||X12 Approved|
|820 – Premium Payment (Capitation File) – Version 1.3.1, updated 2-26-2013||OR-MMIS Technical Specifications||X12 Approved|
|834 Supplement - Language Code Crosswalk||OR-MMIS Technical Specifications||Quick reference|
|834 Supplement - Maintenance Reason Code Crosswalk||OR-MMIS Technical Specifications||Quick reference|
|834 Supplement - Race Code Crosswalk||OR-MMIS Technical Specifications||Quick reference|
|835 - Encounter Remittance Advice – Version 1.2, 11-28-2012||OR-MMIS Technical Specifications||X12 Approved|
|835 - FFS Remittance Advice - Version 1.2, updated 10-12-2012||OR-MMIS Technical Specifications||X12 Approved|
|837 Encounter - Dental, Version 1.2.2, updated 02-26-2013||OR-MMIS Technical Specifications||X12 Approved|
|837 Encounter - Institutional, Version 1.2.2, updated 02-25-2013||OR-MMIS Technical Specifications||X12 Approved|
|837 Encounter - Professional, Version 1.2.2, updated 02-25-2013||OR-MMIS Technical Specifications||X12 Approved|
|837 FFS - Dental||OR-MMIS Technical Specifications||X12 Approved|
|837 FFS - Institutional||OR-MMIS Technical Specifications||X12 Approved|
|837 FFS - Professional, Version 1.3, Updated 7-3-2012||OR-MMIS Technical Specifications||X12 Approved|
|DMAP Registered Clearinghouse List||Eligibility verification, Registration||Quick reference|
|Encounter Data Submission Guidelines||Submitting||Handbook|
|How to complete the 835 Signup Form||Registration||Quick reference|
|How to complete the EDI Registration Packet||Registration||Self-paced|
|ICD-10 EDI Testing Fact Sheet||ICD-10, Testing||Quick reference|
|NCPDP Encounter||OR-MMIS Technical Specifications||Quick reference|
|Password Change Instructions||Testing||Quick reference|
|Plan Codes Crosswalk||Eligibility verification, OR-MMIS Technical Specifications||Quick reference|
|Step-Up Step-Down Known Limitations||Testing||Quick reference|
|Third Party Testing Fact Sheet||Testing||Quick reference|
The EDI Administrative Rules (Chapter 943, Division 120, "Electronic Data Transmission") establish the registration process and requirements applicable to Oregon Medicaid Trading Partners or EDI submitters. They also govern the conduct and requirements for all EDI transactions with Oregon Medicaid.
Tips for submitters
- Clean mailboxes regularly - Delete old files to make sure there is room for new transactions, including 999 and TA1 transactions.
- Change password every 45 days - You will not get reminders to update your password ahead of time.
- 10 failed logins will block your IP address. If you have multiple users accessing your mailbox at the same IP address, limit the number of users and/or make sure everyone knows of password changes at the same time. Make sure scripts and FTP software you use do not automatically try to reconnect after a failed login.
- Submitters east of the Pacific Time Zone - Only send transactions when the transmission date for your zone is the same as the Pacific Time Zone.