OAR 436-160-0405
Insurers’ Reporting Responsibilities

(1)

Insurers with an average of at least 100 accepted disabling claims per year, based on the average accepted disabling claim volume for the previous three calendar years, are required to electronically submit detailed medical bill payment data to the Department of Consumer and Business Services under OAR 436-160-0415 (Oregon ASC X12 837 Medical Bill Data Reporting Requirements).

(2)

The director will notify an insurer when the insurer has reached a three-year average accepted disabling claim count of at least 100. The insurer is required to report medical bill payment data beginning with the date specified in the notice and must continue to report in subsequent years.

(3)

If the insurer’s claim count drops below an average of 50 accepted disabling claims, based on the average accepted disabling claim volume for the previous three calendar years, insurers may apply to the director for an exemption from the reporting requirement.

(4)

The list of insurers required to report medical bill data is published in Bulletin 359.

(5)

Insurers that do not meet the requirement to submit medical data under (1) of this rule may voluntarily submit medical billing data.

Source: Rule 436-160-0405 — Insurers’ Reporting Responsibilities, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=436-160-0405.

Last Updated

Jun. 8, 2021

Rule 436-160-0405’s source at or​.us