Minnesota statute 62J.536 requires that all claims (837I and 837P) submitted to Hennepin Health must be submitted electronically. Paper claims will not be accepted. Additionally, submissions must adhere to the following standards:
Providers are required to adhere to State of Minnesota Uniform Companion Guide requirements and the Administrative Uniformity Committee (AUC) Best Practices for claims submissions. You can find these documents on the AUC website.
We have developed Companion Guides (listed above) to clarify and specify data content for Hennepin Health electronic exchanges. The guides are intended to highlight Hennepin Health-specific data requirements and provide guidance on items that frequently cause rejections.
The guides convey information that is within the framework of the ASC X12N Implementation Guides adopted for use under HIPAA. The Companion Guides are not intended to convey information that in any way exceed the requirements or usages of data expressed in the Implementation Guides.
Delta Dental of Minnesota is our primary provider network for dental services. We use Navitus as our pharmaceutical benefit manager for pharmacy services for all plan members.
We contract with Payer Connectivity Services (PCS) to receive, test and send HIPAA-compliant mandated transactions. We do not contract directly with providers as trading partners. PCS, on behalf of Hennepin Health, works with several clearinghouses. To become a trading partner with us, contact one of the following clearinghouses. Additionally, please complete the Provider Information Form and W-9 found on Hennepin Health's Forms page.
Note: Availity is not a direct submitter of 837 claim transactions to Hennepin Health. Providers using Availity as their claims submission clearinghouse can contact Availity directly to find out how these are routed to Hennepin Health.
If you are unable to send electronic institutional and professional claims, and/or electronic replacement/cancel claims, Hennepin Health, along with several other large Minnesota group purchasers, has secured the services of HealthEC (aka MN e-Connect) to provide free web-based services for provider data entry of ANSI X12 837 v5010 and AUC compliant claims.
You must sign up to receive ACH payments for claims by completing a Hennepin County Automated Clearinghouse ACH enrollment form. If you do not choose to receive ACH payments, you will receive a Hennepin County physical check (Hennepin Health is a Hennepin County department) along with the accompanying electronic remittance advice. ACH payments with accompanying electronic remittance advice documents are the preferred payment methodology unless otherwise specified. If the address on the check and/or the remittance does not match, is incorrect or needs to be updated, immediately contact Hennepin Health Provider Services at 612-596-1036, press 2 (800-647-0550), TTY 711. Claim payments are made on a weekly basis.
We do not distribute paper remittance advice. In order to receive 835 transactions, please contact one of the clearinghouses listed above. Once you have enrolled with one of the clearinghouses, the clearinghouse will contact Hennepin Health to complete the registration process.
612-596-1036, press 2