Certain services require prior authorization for Hennepin Health members. The prior authorization document (DOC) outlines which services require prior authorization or notification to Hennepin Health. Providers are responsible for verifying eligibility and benefits before providing services to members.
Providers can submit claims through one of the following electronic data interchange (EDI) clearinghouses:
ClaimLynx: 952-593-5969 (claimlynx.com) Infotech Global, Inc. (also known as MN E-Connect): 1-877-444-7194 (mneconnect.com) Emdeon: 1-877-271-0054 (emdeon.com/contactus/) OfficeAlly: 360-975-7000 (cms.officeally.com) RelayHealth: 1-800-778-6711 (relayhealth.com)
Non-participating providers: Prior to submitting a claim, you must complete and submit a provider information form (PDF) and a W9 for non-contracted providers form (PDF). To prevent a delay in your claim being processed, please make sure the form is filled out accurately and completely. If you have any questions regarding claim inquiries, please contact Provider Services at 612-596-1036 from 8 a.m. to 4:30 p.m., Monday through Friday.
The referral requirements for accessing out-of-network providers differ between the ACO defined partnership network and in-network non-ACO partner providers. This FAQ provides tips and answers common questions.
The Rendering Provider Procedure Code List (XLS) is a reference document that contains procedure codes for when an individual rendering provider is required to be at the claim or service line levels of an 837 claim transaction. Click here to read the related bulletin for more information.
The SNIP 0-8 Error Code List (XLS) is a reference document that contains a list of the error codes and corresponding error code descriptions for SNIP Levels 0 through 8 testing on 837 claims transactions. Click here to read the related bulletin for more information.
Hennepin Health Claims System Enhancement: On July 12, 2018, Hennepin Health’s claims system was enhanced to include the use of Optum Claim Edit System™ (CES) software. The enhancement is applicable for all new and adjusted professional (837P) and institutional (837I) claims for Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members. Learn more.