Minnesota Law Requires Electronic Exchange of Eligibility, Claims, and Remittance Advice Transactions

MN statute section 62J.536 requires all Minnesota health care providers and Minnesota licensed group purchasers to exchange eligibility inquiries and response, claims, and remittance advices electronically using a standard format. This effort reduces costs, simplifies and speeds up health care transactions while giving providers and health plans one set of standards.

Review answers to Minnesota Mandate Questions.

HealthPartners no longer accepts paper claim submissions from Minnesota providers.

Options for providers who are not currently electronic

HealthPartners offers several options for exchanging mandated transactions:

HealthPartners has contractual relationships with several clearinghouses that offer Electronic Data Interchange (EDI) capabilities and internet Direct Data Entry (DDE) solutions.

• Claims Submissions
• Electronic Remittance Advice
• Eligibility Inquiry and Response
• HealthPartners Web Tools

To help determine which clearinghouse best meets your business needs; please contact them directly by utilizing the contact information provided on our web site.

MN Companion guides and additional information for mandated transactions

For additional resources regarding these mandates visit:

• The Administrative Simplification Act (ASA) at https://www.cms.gov/
• The Administrative Uniformity Committee (AUC) at health.state.mn.us/auc

For information on upcoming MN mandates visit the Minnesota Department of Health Website.

Administrative Uniformity Committee (AUC)

HealthPartners participates in the AUC, a broad-based group representing Minnesota health care public and private payers, hospitals, health care providers and state agencies.

The mission of the AUC is to develop agreement among Minnesota payers and providers on standardized administrative processes when implementation of the processes will reduce administrative costs.

Learn more about MinnesotaCare health reform section 62J.536 and about the Administrative Uniformity Committee (AUC).