Last updated: 5/23/2024
Medical Billing Data EDI Trading Partner Profile {4015}
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Description
4015 - MEDICAL BILLING DATA EDI TRADING PARTNER PROFILE. This form is used to establish and register a trading partner for electronic data interchange (EDI) with the Oregon Workers’ Compensation Division. It gathers detailed information about the trading partner, including their type (such as insurer, employer, service provider), legal name, sender ID (Federal Employer Identification Number and postal code), physical and mailing addresses, and contact details for both business and technical inquiries. This information ensures proper setup and identification for exchanging medical billing data electronically between the trading partner and the Workers' Compensation Division. www.FormsWorkflow.com
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