Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-1 - General Provisions
Section 5160-1-20 - Electronic data interchange (EDI) trading partner enrollment and testing
Current through all regulations passed and filed through September 16, 2024
(A) For purposes of this rule, the following definitions apply:
(B) Responsibilities of trading partners.
(C) Testing criteria for trading partners.
(D) Passing criteria for transactions tested.
(E) Trading partners that are not actively submitting and receiving 837 health care claim transaction sets but who are actively submitting and receiving 270/271 and 276/277 transaction sets are to provide, in a manner specified by ODM, a report of all providers by national provider identifier (NPI) that the trading partner represents. The first report is due at the time of initiating a trading partner agreement with ODM. Subsequent reports are due quarterly based on the calendar year, no later than January first, April first, July first and October first. If the necessary reports are not submitted, the trading partner agreement will be denied or terminated, as applicable.
(F) If a trading partner does not submit or receive EDI transactions for a period of two years or longer, ODM may terminate the trading partner agreement without notice.
(G) Trading partners are responsible for any breach of information and will be held fully liable for any and all costs related to such a breach.
Replaces: 5160-1-20