All claims (837I and 837P) submitted to Hennepin Health must be submitted electronically. Paper claims will not be accepted. This process is because we follow legislative standards outlined in Minnesota statute 62J.536. Submissions must follow one of 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 in the left column) to clarify and specify data content for Hennepin Health electronic exchanges. The guides are also 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 that specialize in claim data exchange (eligibility, professional and institutional claims, and remittance advice).
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 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.
ACH payments are preferred. Claim payments are made on a weekly basis.
To receive ACH payments for claims, complete the Hennepin County Automated Clearinghouse ACH Enrollment form.
If you do not choose to receive ACH payments, you will receive a physical check from Hennepin County along with the accompanying electronic remittance advice.
We do not distribute paper remittance advice. ERAs are typically sent to the same clearinghouse that submitted the claim. If you want the ERA sent to a different clearinghouse, refer to the 835 Companion Guide for instructions.