Or. Admin. Code § 836-100-0110

Current through Register Vol. 63, No. 12, December 1, 2024

Section 836-100-0110 - Adoption of Standards

(1) All health insurers and health care entities must conduct eligibility benefit inquiry and response transactions with health care providers as electronic transactions that conform to the uniform standards developed by the Office for Oregon Health Policy and Research pursuant to section 3, chapter 130, Oregon Laws 2011 (Enrolled Senate Bill 94) as set forth in the Oregon Companion Guide for Health Care Eligibility Benefit Inquiry and Response in accordance with the following schedule:

(a) On and after January 1, 2012 for those health care providers that submit the inquiry electronically on the effective date of these rules.

(b) On and after October 1, 2012, for all inquiries from all health care providers.

(2) All health insurers and health care entities must conduct claims or encounter transactions with health care providers in conformance with the uniform standards developed by the Office for Oregon Health Policy and Research pursuant to section 3, chapter 130, Oregon Laws 2011 (Enrolled Senate Bill 94) as set forth in the Oregon Companion Guide for Health Care Claim: Professional, Oregon Companion Guide for Health Care Claim: Institutional and Oregon Companion Guide for Health Care Claim: Dental in accordance with the following schedule:

(a) On and after October 1, 2012 for those health care providers that conduct claims or encounter transactions electronically on the effective date of these rules.

(b) On and after January 1, 2013, all claims or encounter transactions with all health care providers must be conducted electronically.

Or. Admin. Code § 836-100-0110

ID 12-2011, f. & cert. ef. 7-15-11; ID 16-2011, f. & cert. ef. 10-31-11

Stat. Auth.: ORS 731.244 & 2011 OL Ch. 130 Sec. 2 (Enrolled SB 94)

Stats. Implemented: 2011 OL Ch. 130 Sec. 2 (Enrolled SB 94)