Submitting Claims - Minnesota Dept. of Health

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.

  • 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
    Attention: Non-MDH link
  • 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
    Attention: Non-MDH link

Updated Friday, October 09, 2015 at 01:20PM