Oregon Health Plan EDI FAQs- Registration
Oregon Health Plan EDI FAQs (the first portion) were already given in the earlier post. Today we continue to present you Oregon Health Plan EDI FAQs in order to release more information about Oregon Health Plan EDI initiative. The Oregon Health Plan EDI FAQs given below will be helpful for those parties that somehow are connected to electronic documents exchange with Oregon Health Plan, including claims program.
What is a Trading Partner Agreement (TPA)? – The TPA defines the “terms of agreement” between the Trading Partner, the EDI submitter (entity sending/receiving the transactions) and Oregon Medicaid. It requires the signature of the people authorized to enter into this contract. You will also indicate the transactions authorized and who will send/receive them. The Trading Partner Agreement (TPA) is a binding agreement between Oregon Medicaid and a provider (OAR 943-120-0100). Oregon Medicaid requires all of those planning to do electronic business with Oregon Medicaid to sign a Trading Partner Agreement before testing.- Can we have multiple contact persons on the Trading Partner Agreement? – Yes. Multiple contacts are allowed. The Trading Partner Agreement allows for seven different contacts: Two provider contacts for contact or authorized signer, another two provider contacts for claims inquiries, and three contacts for the EDI submitter. If you want to have additional contacts you may add them. Additional contact information should be on “Company Letterhead” and attached to the TPA or may be written on the back of the form.
- Are pharmacies required to submit a Trading Partner Agreement? – Pharmacies must complete a TPA for the following:
- To submit 837P Professional claims (e.g., for durable medical equipment or medication management services). Register for the 837P transaction.
- To receive the 835 (Electronic Remittance Advice). Register for the 835 transaction.
- Pharmacies who only exchange transactions via point of sale or the Provider Web Portal, and who do not want the electronic RA, do not need to submit a TPA or register for transactions.
Still not ready for EDI implementation? Sign up for HIPAA EDI and EDI All Industries courses at EDI Academy!