Frequently Asked Questions (FAQs)
The following FAQs are provided for information and clarification. They will be revised and updated as needed. Additional information regarding Minnesota Statutes, section 62J.536 and related rules is available at on the Minnesota Department of Health Administrative Simplification Act website.
Last revised: 1/30/2012
Category 5 - Implementation, becoming compliant with the state law and rules
There are many options for providers to connect electronically with payers, ranging from direct Electronic Data Interchange (EDI) connections, to contracting with a variety of vendors and services (e.g., clearinghouses, billing services, etc.) to secure web-based “direct data entry” tools that allow providers to directly key in and transmit Minnesota-compliant claims to payers. It will be important to evaluate options to find those that best meet your business needs. Many providers are consulting with their associates, payers, business advisors, professional and trade associations, and others for advice and possible recommendations.
MDH does not have a list of recommended vendors. As noted in the answer to Question 1, there are many options for providers to connect with payers electronically, and it is important for providers to find the option that best meets their needs. MDH does not require use of any particular vendor or services and does not endorse or recommend any particular vendors.
MDH does not have responsibilities or resources for offering free or low cost electronic connectivity and MDH will not be providing such a service.
Note: Another state agency, the Minnesota Department of Human Services (DHS), maintains a secure web portal called MN-ITS for providers to submit claims for free for patients who are covered under DHS public programs such as Medical Assistance or MinnesotaCare.
In 2009, the Minnesota Council of Health Plans announced the availability of a direct data entry web portal for providers to submit health care claims to participating group purchasers at no cost to the provider (for additional information about this option, please see the HealthEC website). MDH is not aware whether there may be other web portal options available at a low cost or no cost to providers. Again, as noted previously in these FAQs, MDH does not require or endorse any products or vendors.
Providers should contact their payers, or check payers’ websites, for information on how to connect electronically.