EDI Claims Release 3.1 Requirements
Version 1.7 - Revision Date: 06/30/2022, Effective Date: 01/16/2023

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.

Previous Versions

Version 1.6
Revision Date: 04/13/2021, Effective Date: 08/09/2021

Event Table
Element Requirements
Edit Matrix
FROI SROI Sequencing Table

Version 1.5
Revision Date: 12/12/2019, Effective Date: 03/23/2020

Event Table
Element Requirements
Edit Matrix