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Electronic Data Interchange Resources

Use the resources on this page to correctly register, test and exchange EDI information with OHA.


Receive EDI updates by text or e-mail or view the most recent changes.

Mailbox access changes effective January 1, 2016

The Oregon Health Authority is changing the way its trading partners access their EDI mailbox. This change will help ensure access to the mailbox in the event of a disaster.

In a transition that began January 1, 2016, partners will use the host name instead of the mailbox URL. 

If you do not have the host name or if you have questions about this change, please have your authorized technical contact send an email to DHS.EDISupport@state.or.us

Please note that this change does not apply to the Provider Web Portal at https://www.or-medicaid.gov.


Registration forms​

To register as an Oregon Medicaid trading partner, complete the EDI Registration Packet (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.

  
Description
OHP 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.

OHP 2081 (Packet Pages 6-8)

Exhibit A of the TPA gives Oregon Medicaid information on who will be submitting your electronic transactions.​

OHP 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. ​

OHP 2083

Use Exhibit C to update contact information listed on Exhibit A and add or delete your registered transaction on Exhibit B. ​

OHP 2080PKT

To register as an Oregon Medicaid trading partner, complete all three forms in this packet (2080, 2081 and 2082).​


Other resources

As Oregon MMIS Technical Specific​ations 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

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).

Looking for encounter data information?  Encounter-only technical specifications and other documents are now on the OHP Encounter Data page.


  
Topic
  
  
270 - Eligibility InquiryOR-MMIS Technical SpecificationsX12 Approved
271 - Eligibility ResponseOR-MMIS Technical SpecificationsX12 Approved
271 Supplement - Carrier Code ListEligibility verification, OR-MMIS Technical SpecificationsQuick reference
271 Supplement - EB ValuesOR-MMIS Technical SpecificationsQuick reference
271 Supplement - EB05 Benefit DescriptionsEligibility verification, OR-MMIS Technical SpecificationsQuick reference
276 - Claim Status InquiryOR-MMIS Technical SpecificationsX12 Approved
277 - Claim Status ResponseOR-MMIS Technical SpecificationsX12 Approved
835 - FFS Remittance Advice - Version 1.2, updated 10-12-2012OR-MMIS Technical SpecificationsX12 Approved
837 FFS - DentalOR-MMIS Technical SpecificationsX12 Approved
837 FFS - InstitutionalOR-MMIS Technical SpecificationsX12 Approved
837 FFS - Professional, Version 1.3, Updated 7-3-2012OR-MMIS Technical SpecificationsX12 Approved
How to complete the 835 Signup FormRegistrationQuick reference
How to complete the EDI Registration PacketRegistrationSelf-paced
ICD-10 EDI Testing Fact SheetICD-10, TestingQuick reference
OHA Registered Clearinghouse ListEligibility verification, RegistrationQuick reference
Password Change InstructionsTestingQuick reference
Plan Codes CrosswalkEligibility verification, OR-MMIS Technical SpecificationsQuick reference
Step-Up Step-Down Known LimitationsTestingQuick reference
Third Party Testing Fact SheetTestingQuick reference

OHA policy

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.
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