EDI Proof of Coverage Information

Any new trading partner must complete the Trading Partner Documents as the first step in the testing process.

The forms below have Maine specific information for EDI POC data elements based on IAIABC standards of POC Release 3.0.

POC Event Table -The Event Table will provide trigger criteria for each triplicate code. The table also provides the timelines for when each type of transaction should be sent based on the event that is being triggered.

POC Element Requirement Table- The Element Requirement Table contains all of the data elements that the Maine Workers' Compensation Board accepts. This table also includes the severity of each element for each triplicate code. You will also find conditional requirements in this table.

POC Edit Matrix Table -The Edit Matrix Table is a table which includes applied editing based on the IAIABC standards and Maine's POC data requirements.

Implementation Guide

An IAIABC POC R3.0 Implementation Guide can be purchased and downloaded from the IAIABC website. The guide provides detailed information regarding system information, code tables, scenarios, data elements, etc.
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Frequently Asked Questions about EDI Proof of Coverage