Providers - Learn how to exchange HIPAA-compliant health care transactions with OHA.
New to EDI?
First, read our Oregon Health Plan electronic business practices guide. If you do not use a billing service or clearinghouse, and submit a small number of claims per week, the Provider Web Portal may be right for you.
If you still want to sign up for EDI, follow these steps:
- If you use a clearinghouse, see if yours is registered with OHA. This list does not imply any endorsement by OHA of services or products listed.
- Once you know who will submit EDI transactions for you, complete OHA's Trading Partner Agreement (TPA) for Electronic Health Care
Transactions (OHA 2080). Both the provider and EDI submitter must read and sign this form. To learn more, read How to complete the TPA.
- Sign the form (do not use black ink). Make a copy for your records.
- Mail the form with original signature to EDI Support Services. OHA does not accept forms by fax or email, and does not accept stamped signatures.
If any required fields are incomplete, OHA will contact the authorized signer. Once your TPA is approved, OHA will email the technical contact listed in Part 5 of your TPA to begin testing.
Once testing is complete:
Sign up to receive EDI updates to find out about changes that may affect your EDI transactions to OHA, such as:
- Updates to Oregon MMIS technical specifications
- Oregon MMIS downtime notices
- Updates to the TPA form
Notify OHA of any material changes by submitting a new TPA
Do this within 10 business days of the change. The 2-page TPA (OHA 2080) must be signed by the authorized signer on your current TPA. (If your EDI submitter has changed, your new EDI submitter must also sign.) Material changes include changes to:
- Authorized signers, transactions and EDI submitter
- Any related contact information
- Your Oregon Medicaid ID, business name or Tax ID
Keep a current Trading Partner Agreement on file
- OHA now denies claims from EDI submitters who are not listed on your current TPA with OHA. Read the EDI update about this change (effective 1/1/2017).
- If your claims deny for this reason, you need to submit a new TPA listing your current submitter. To do this, use the 2-page OHA 2080 (revised 7/17). OHA will accept only TPA information submitted on the current 2-page form.
- OHA does not accept incomplete TPA forms. To make sure you complete the TPA right the first time, please read our line-by-line instructions in How to complete the TPA. If you fill out the current TPA form electronically, required fields have a red border.
- If you don't know who is listed on your current TPA, or do not have a copy of it, please submit a new TPA. OHA can only share information with the authorized contacts on your current TPA. It is your responsibility to keep a copy and send a new TPA when the contacts change.