Oregon Administrative Rules › Chapter 943 - OREGON HEALTH AUTHORITY › Division 120 - PROVIDER RULES › Section 943-120-0140 - Trading Partner Agents as EDI Submitters - EDI Transactions

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Responsibility for Agents. If a trading partner uses the services of
			 an agent, including but not limited to an EDI submitter in any
			 capacity in order to receive, transmit, store, or otherwise process
			 data or data transmissions or perform related activities, a trading
			 partner shall be fully responsible to the Authority for the agent's
			 acts.
(2) Notices
			 Regarding EDI Submitter. Prior to the commencement of an EDI
			 submitter's services, a trading partner must designate in the
			 application for authorization the specific EDI submitters that are
			 authorized to send and receive data transmissions in the performance
			 of EDI transactions of a trading partner. A trading partner must
			 complete the "Trading partner Authorization of EDI Submitter" and the
			 "EDI Submitter Information" required in the application. A trading
			 partner must also submit the EDI registration form identifying and
			 providing information about an EDI submitter. A trading partner or
			 authorized EDI submitter must notify the Authority of any material
			 changes in the EDI submitter authorization or information no less
			 than five days prior to the effective date of the changes.
(3) EDI Submitter Authority. A
			 trading partner must authorize the actions that an EDI submitter may
			 take on behalf of a trading partner. The application for
			 authorization permits a trading partner to authorize which decisions
			 may only be made by a trading partner and which decisions are
			 authorized to be made by an EDI submitter. The EDI submitter
			 information authorized in the application for authorization will be
			 recorded by the Authority in an EDI submitter profile. The Authority
			 may reject EDI transactions from an EDI submitter acting without
			 authorization from a trading partner.
(4) EDI Submitter Certification
			 Conditions. Each authorized EDI submitter acting as an agent of a
			 trading partner must execute and comply with the EDI submitter
			 certification conditions that are incorporated into the application
			 for authorization. Failure to include the signed EDI submitter
			 certification conditions with the application shall result in a
			 denial of EDI submitter authorization by the Authority. Failure of an
			 EDI submitter to comply with the EDI submitter certification
			 conditions may result in termination of EDI submitter registration
			 for EDI transactions with the Authority.
(5) EDI Submitters
			 Responsibilities. In addition to the requirements of section (1) of
			 this rule, a trading partner is responsible for ensuring that an EDI
			 submitter makes no unauthorized changes in the data content of all
			 data transmissions or the contents of an envelope, and that an EDI
			 submitter will take all appropriate measures to maintain the
			 timeliness, accuracy, truthfulness, confidentiality, security, and
			 completeness of each data transmission. A trading partner is
			 responsible for ensuring that its EDI submitters are specifically
			 advised of, and will comply with, the terms of these rules and any
			 TPA.
Stat. Auth.: ORS
				  413.042  &414.065
Stats. Implemented: ORS
				  413.042 &
				  414.065