Submitting Claims

A claim is a request for payment submitted by the health care provider to the health plan when services are rendered. Insurance claims can be submitted through a medical claims management system or a direct data entry system. Minnesota State Statute, section 62J.536, requires all health care providers to submit claims, including secondary claims, electronically using a standard format.

The review of a claim involves multiple administrative and customer service layers that include review, investigation, adjustment (if necessary), remittance or denial of the claim. A Remittance Advice (RA) is a document supplied by the health plan that provides notice and explanation of payment, adjustment, denial and/or uncovered charges of a medical insurance claim.

• Minnesota Department of Human Services: Basic Instructions
• Minnesota Department of Human Services: Use MN–ITS Request Claim Status (276/277) to Check the Status of a Claim 
  Minnesota Health Care Programs (MHCP)-enrolled providers can submit claims, check their status and receive RA through MN-ITS or through a clearinghouse.
  Provider Help Desk Phone: 651-431-2700
• Connex
  Medicare-enrolled providers can submit claims, check their status and receive RA through the National Government Services (NGS) Connex, its secure provider portal, or through approved clearinghouses.
  Provider Help Desk Phone: 866-234-7340
• Availity Log-in
  Blue Cross and Blue Shield of Minnesota-contracted providers can submit claims, check their status and receive RA through Availity or through other approved clearinghouses.
  Provider Help Desk Phone: 651-662-5200
• HealthPartners: Provider Home
• HealthPartners: Claims submission
• Health Partners: Electronic remittance advice 
  HealthPartners-contracted providers can submit claims through clearinghouses approved by the health plan. Providers can check a claim’s status and receive RA through the HealthPartners provider portal or through approved clearinghouses.
  Commercial Plan Provider Help Desk Phone: 952-967-6633
  MHCP Plan Provider Help Desk Phone: 952-883-7699
• Medica: Electronic Transactions: Provider Login
• Medica: Administrative Resources
  Medica-contracted providers can submit claims through clearinghouses approved by the health plan. Providers can check a claim’s status and receive RA through the Medica provider portal or through approved clearinghouses.
  Provider Help Desk Phone: 800-458-5512