Or. Admin. Code § 436-162-0320

Current through Register Vol. 63, No. 12, December 1, 2024

Section 436-162-0320 - Acknowledgement

(1) The division will respond to submitted transmissions with either a transaction accepted or a transaction rejected acknowledgement. The division may, at its discretion, reprocess transactions.

(2) A transaction rejected acknowledgement will be sent for all transactions incapable of being processed by the division's information processing system, including, but not limited to:

(a) An omitted mandatory data element;

(b) An improperly populated data element field, e.g., numeric data element field is populated with alpha or alphanumeric data, or is not a valid value;

(c) Transactions or electronic records within the transaction which require matching and cannot be matched to the division's database;

(d) Illogical data in mandatory or required conditional field, e.g., termination date is before coverage effective date;

(e) Duplicate transmission or duplicate transaction within the transmission;

(f) Invalid triplicate code; or

(g) Illogical event sequence relationship between transactions, e.g., endorsement transaction submitted before a policy transaction is submitted.

(3) The insurer must correct and resubmit any transactions rejected for which law or rule require filing, reporting, or notice to the director.

(4) Insurers are not required to resubmit reprocessed transactions.

(5) A transaction accepted acknowledgement will be sent for all transactions that are in a format capable of being processed by the division's information processing system and are not rejected pursuant to section (2) of this rule.

(6) An insurer's obligation to file proof of coverage for the purposes of this rule is not satisfied unless the director acknowledges acceptance of the transaction.

Or. Admin. Code § 436-162-0320

WCD 3-2003, f. 3-18-03, cert. ef. 4-1-03; WCD 12-2003, f. 12-4-03, cert. ef. 1-1-04; WCD 4-2008, f. 9-17-08, cert. ef. 7-1-09; Renumbered from 436-160-0320, WCD 7-2010, f. 10-1-10, cert. ef. 1-1-11

Stat. Auth: ORS 656.726(4)

Stat. Implemented: ORS 656.264