Hennepin Health follows the legislative standards outlined in Minnesota statute 62J.536. Per this statute, all claims submitted to Hennepin Health must be submitted electronically, following American National Standards Institute standards, Accredited Standards Committee X12 transactions standards or National Council for Prescription Drug Program (NCPDP) standards.Paper claims will not be accepted.
Providers are required to adhere to State of Minnesota Uniform Companion Guide requirements and the Administrative Uniformity Committee (AUC) Best Practices for claims submissions. These documents are available on the AUC website.
Hennepin Health contracts with Payer Connectivity Services (PCS), part of Change Healthcare, to receive, test and send HIPAA-compliant mandated transactions. Services provided by PCS can be performed in batch transactions or as real-time transactions. Hennepin Health does not contract directly with providers as trading partners. PCS, on behalf of Hennepin Health, works with several clearinghouses. If you would like to become a trading partner with Hennepin Health, please contact one of the following clearinghouses:
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 Infotech Global, Inc. (aka MN e-Connect) to provide free Web-based services for provider data entry of ANSI X12 837 v5010 and AUC compliant claims.
Availity is not a direct submitter of 837 (claims) transactions to Hennepin Health. Providers using Availity as their claims submission clearinghouse can contact Availity directly to learn how these are routed to Hennepin Health.
Electronic Remittance Advises (ERAs) will be sent to the same clearinghouse submitting the 837 transactions on behalf of the service provider. If you would like the ERA to be sent to a different clearinghouse other than the one used for claims submissions, refer to the implementation checklist outlined in Hennepin Health’s 835 Companion Guide.