Providers are scrambling to comply. Here are tools to help.
What: Minnesota Statutes, section 62J.536, require all health care providers and group purchasers (payers, plans) to exchange eligibility inquiries and responses, claims, and remittance advices electronically, using a standard format, effective in 2009. If you submit paper claims, you should explore your options for electronic billing and prepare to be in compliance by 2009.
How: The Minnesota Department of Health (MDH) with the Minnesota’s Administrative Uniformity Committee (or AUC, the broad-based group of providers and payers listed below) will provide guides to standardize the way you check eligibility, submit claims and receive remittance advices in an electronic format for all Minnesota health payers. Visit the AUC website online at www.health.state.mn.us/asa to learn more.
Why: To reduce costs, simplify, and speed up health care transactions, and give providers and health plans one set of standards.
Who: This statute applies to all health care providers that check eligibility, submit claims and/or receive RAs. It also applies to all health plans and payers.
Health care claim (837P, 837I, 837D and NCPDP 5.1)
July 15, 2009
Payment/remittance advice (835)
Dec. 15, 2009
Next Steps for You as a Provider:
- Watch for more information on the websites of Minnesota’s health plans.
- Consider your options for how you will verify eligibility, submit claims and receive your RA electronically.
- Update practice management system, billing service, clearinghouse or web-based portals.
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