EDI Claims Release 3.1 Requirements
Version 1.6 - Revision Date: 04/13/2021, Effective Date: 08/09/2021
Download the Requirements by clicking on the links below.
The Requirements are housed in three tables:
- Event Table
- This table relates EDI information to the circumstances under which they are initiated as well as the timeframes for sending the information.
- Element Requirements
- This table lists the individual data element requirements
- Edit Matrix
- This table provides information on the edits that will apply to each data element and the edits that will be applied based on the population of the data element.
- FROI SROI Sequencing Table
- This table provides information on the Jurisdiction's MTC sequencing. It is meant to convey to the Trading Partner the sequencing rules that clarify how the Jurisdiction will apply Edit 063 - Invalid Event Sequence. This information does not supersede or replace the sequencing stipulated in the Edit Matrix.