Minnesota AUC Home News Calendar Technical Advisory Groups About Archives Administrative Simplification Forms MN Uniform Companion Guides Best Practices Coding FAQs Links MN Department of Health		4010 Best Practices Version 4010 of the Minnesota Uniform Companion Guides was discontinued as of December 31, 2011. Corresponding Minnesota AUC best practices have been posted for archival purposes only. Best Practice Transaction Summary/Purpose V4010 270/271 Eligibility Inquiry and Response Verifying eligibility 270 Provides recommendations for providers to facilitate verifying a patient’s eligibility with a group purchaser. pdf-3pgs Reporting patient financial responsibility 271 Outlines how to report known patient financial responsibility in the 271 eligibility response. pdf-3pgs Timely enrollment reporting requirements 270/271 reporting Provides guidance for group purchasers and clearinghouse users regarding how and when patient enrollment updates should be implemented. pdf-2pgs 837 Health Care Claim: Professional (P), Institutional (I), and Dental (D) MN community coding recommendation grid 837P, 837I The MN community coding grid consists of medical coding recommendations. It is updated on a regular basis as needed, and the recommendations in the grid are approved and used in the same manner as best practices. pdf-19pgs Provider coordination of benefits (COB) claims data population 837P, 837I, 837D Provides assistance to providers and group purchasers for payer to payer COB transactions. Note: MS 62J.536 does not apply to payer to payer COB. pdf-2pgs Format of claim submitter’s identifier 837P, 837I, 837D Outlines for providers how to best format and submit patient control/account numbers in the claims transaction. pdf-2pgs Utilization of the basic character set values 837P, 837I, 837D Explains best use of the basic character values in the claims transaction. pdf-2pgs Reporting services and charges related to adverse health events 837I Provides additional guidance to providers submitting a claim that contains both services that are related to an adverse health event and those that are not. pdf-3pgs Taxonomy submission requirements 837P, 837I, 837D Indicates situations where taxonomy code(s) should be included in the claim record as it will impact the adjudication of the claim. pdf-2pgs Claims attachments Links to 4010 version of attachment cover sheet is no longer available. Please see 5010 version and instructions (pdf). 837P, 837I, 837D Provides guidance on how to complete and send an attachment that is related to a submitted claim. Attachment cover sheet instructions Attachment cover sheet AUC member contact information for faxing claims attachments and appeals forms Note: Claims attachment cover sheets should be sent to the appropriate group purchaser and not MDH or AUC. pdf-3pgs Hearing aid model numbers in NTE segment 837P Outlines how to submit hearing aid model numbers as part of a claim, avoiding the need to submit the numbers as a claims attachment. pdf-1pg Miscellaneous supply/product numbers in NTE segment 837P, 837I Provides guidance for submitting codes for miscellaneous supplies/products as part of a claim, avoiding the need to submit the codes as claims attachments. Note: This best practice does not apply to institutional inpatient claims. pdf-2pgs COB claims when primary payer is not a MN group purchaser 837P, 837I, 837D Gives instructions for submission of a secondary claim when the primary claim is submitted to a payer who is not a group purchaser covered under MS 62J.536. pdf-2pgs Claim service dates restricted to same calendar month 837P, 837I, 837D Most patient eligibility changes occur at the beginning/end of a calendar month. Some systems require claims contain only services that are associated with a particular eligibility period, and current practice is to split these claims. The purpose of this best practice is to provide guidance in order to avoid split claims and rejections. pdf-2pgs Product and supply description in NTE segment 837P, 837I Provides guidance for submitting descriptions of a product or supply as part of a claim, avoiding the need to submit the codes as claims attachments. pdf-2pgs Replacement/ void claims 837P, 837I, 837D Clarifies definitions, identification and handling of replacement and void claim types. Note: Replacement claims may also be referred to as “corrected claims”; void claims may also be referred to as “cancel claims”. pdf-3pgs Submission of appeals 837P, 837I, 837D Provides instruction for submitting an appeal by a provider to a Minnesota group purchaser. Appeal request form instructions Appeal request form AUC member contact information for faxing claims attachments and appeals forms Note: Claims appeal request forms should be sent to the appropriate group purchaser and not MDH or AUC. The attachment cover sheet must not be sent with the appeal request form. pdf-2pgs Coordination of benefits/non-assignment of primary payer benefits 837P, 837I, 837D Provides guidance on how the secondary or tertiary group purchaser can determine whether they need to request the payment information from the patient rather than the provider, or adjust as patient liability, in situations in which the patient initially received the EOB/payment. pdf-2pgs Coding for preventative medicine visit with a separately-identifiable, problem-oriented service during the same encounter 837P, 837I, 837D This best practice states that the comprehensive work required to establish a patient/physician relationship is completed when a preventive medicine service is provided. Therefore, an established patient E/M code should be used to report a separately-identifiable problem-oriented E/M service in addition to a preventive medicine service on the same date. pdf-2pgs Billing for postage services 837P, 837I, 837D Provides instructions for postage billing, which only apply if the provider bills the group purchaser for postage. Some providers do not bill the group purchaser for postage and some contracts exclude coverage for postage. Providers are not required to bill for postage nor are group purchaser required to reimburse for postage. pdf-2pgs Reporting of admission, principal and other procedure, and statement dates 837I This best practice is a revision to current billing requirements of the Minnesota Uniform Companion Guide For the Implementation of the Health Care Claim-Institutional Electronic Transaction (ANSI ASC X12 837I). It explains reporting of admission, principal and other procedure, and statement dates. Note: This best practice is intended for use 10/1/11-12/31/11. pdf-2pgs 835 Claim Payment/Remittance Advice Electronic funds transfer (EFT) 835 Outlines standard EFT processes for providers, group purchasers, and financial institutions wishing to implement this process. Note: MS 62J.536 does not require that providers and group purchasers use EFT as a component of the claim payment/remittance advice transaction. pdf-2pgs Acknowledge receipt of manual full refund 835 Provides guidance for group purchasers acknowledging the receipt of a manual refund check in the 835 transaction. Note: Group purchasers need not acknowledge receipt of a manual refund check in the 835 transaction. pdf-2pgs Balance forward processing 835 Indicates preferred method to report group purchaser recoveries in excess of payments within the 835 transaction. pdf-2pgs Other Dataset to be provided for skilled nursing facility admissions decisions N/A The dataset described in this best practice is an inventory of the information needed by skilled nursing facilities to decide whether they can adequately care for a resident and to prepare for providing that care. pdf-4pgs Back to top		Most Viewed Claims Forms * Attachment Cover Sheet         (Instructions-pdf) * Appeal Request Form    (Instructions-pdf) * Submission Info (pdf) Contact us If you have questions or comments about information on this page email: health.auc@state.mn.us Subscribe to AUC updates Adobe Acrobat Reader to view PDF files (free download from Adobe website)