Claims/billing

Claims/billing

Hennepin Health accepts claims via electronic transactions. Paper claim submissions will not be accepted.

Submit a claim

Before submitting a claim, you should:

• Verify a member’s coverage by asking to see the Hennepin Health member ID card.
• Bill the member’s primary insurance first.

General billing requirements  

• Submit claims after the service has been provided.
• Bill one calendar month of service per claim.
• Bill your usual and customary charge.
• Service date must reflect the date when the service was provided.
• Use valid ICD-10 and CPT codes.
• Include ordering or referring provider’s National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) if applicable.

Hennepin Health members can receive services from out-of-network (within Minnesota) or out-of-area (outside of Minnesota) providers in specific instances. Contact our Provider Services at 800-647-0550 to inquire if the services you provide to a Hennepin Health member may be covered without a contract.

Federally Qualified Health Centers should submit all claims for Hennepin Health members on MinnesotaCare directly to us.

Submit claims through electronic transactions.

Check a claim status

Claims fall into one of three categories: paid, pending, denied. To check a claim status, call the Provider Services team.

Common reasons why claims are denied

• A wrong or invalid code was used.
• The service date doesn’t match the date the service was provided.
• It was not submitted within 180 days from the date of service or admit date for inpatient claims by a contracted provider.
• It was superseded by a void or replacement claim.

Claim adjustment/reconsideration

You may believe a claim was denied in error or incorrectly paid. To dispute a claim, fill out the Claims Adjustment/Reconsideration Request form.

Along with supporting documents, fax the form to 612-321-3786. 

Or mail to:
Hennepin Health 
Attn: Adjustment Department 
300 South Sixth Street MC 604 
Minneapolis, MN 55487-0604  

Timely filing for a claim adjustment/reconsideration request form is 180 days from the paid/denied date of the claim.

Forms

• Automated clearinghouse ACH funds transfer request  
• Client placement authorization
• Non-contracted provider information (PDF, 1MB) 
• W9 for contracted providers  
• W9 for non-contracted providers (PDF, 1MB) 

Find more claims/billing information in the Provider Manual 

Related information

• Fraud and abuse 
• Prior authorization