Navigating the claims process for Minnesota Health Care Programs (MHCP) is crucial for healthcare providers, especially those operating out-of-state. While electronic submission is generally preferred, MHCP acknowledges that paper claims are necessary in certain limited situations, primarily for non-enrolled out-of-state providers. This guide provides essential information on when and how to submit paper claims, focusing on the correct Minnesota Health Care Programs Claims Address to ensure timely and accurate processing.
Who Can Submit Paper Claims to MHCP?
Typically, paper claim submissions to MHCP are reserved for out-of-state providers who are not enrolled in MHCP. To be eligible to submit a paper claim, these providers must be actively enrolled with Medicare or another state’s Medicaid program. Importantly, out-of-state providers are permitted to bill MHCP via paper claim only once before they are required to undergo screening and enrollment with MHCP. For continued billing, enrollment and electronic claim submission through MN–ITS are mandatory, utilizing either direct data entry or compliant electronic data interchange (EDI) methods as outlined in Minnesota’s Uniform Companion Guides.
Essential Guidelines for Paper Claim Submission
To ensure your paper claims are accepted and processed without delays, it is vital to adhere to MHCP’s specific formatting and submission guidelines. All paper claims must be typed or computer-printed and fulfill the following criteria:
Acceptable Claim Forms
Providers must use original, industry-standard claim forms, specifically:
- ADA Dental Claim Forms
- CMS-1500 Health Insurance Claim Form
- UB-04 Uniform Billing Claim Form
MHCP explicitly does not accept faxed, copied, or screen-printed invoices. Utilizing original forms is a fundamental requirement for paper submissions.
General Formatting Rules
Attention to detail in formatting is paramount. Follow these rules meticulously:
- Authorization Forms: Include appropriate authorization request forms when necessary, ensuring all required fields are completed accurately.
- Box Usage: Confine all writing and markings strictly within the designated boxes on the claim form. Avoid writing or marking outside these boundaries.
- Print Quality: Use only black ribbon or print for all text on the claim form.
- Font Restrictions: Refrain from using bold, compressed, cubic, enlarged, italic, mixed, or script typestyles or fonts. Capitalize all alpha characters for clarity and uniformity.
- Symbol Prohibition: Do not use any symbols such as #, $, &, @, !, or % on the claim form.
- Physical Handling: Submit claims unfolded and unstapled. Ensure paper claims are handled with care to prevent damage during mailing and processing.
Claim Attachments
If your claim requires supporting documentation, refer to the MHCP Attachment Criteria to ascertain if attachments are necessary. MHCP may deny claims if unnecessary attachments are included. When attachments are required:
- Use clean 8 ½ x 11-inch paper for all attachment pages.
- Paperclip all pages together with the main claim form; avoid using staples.
Where to Mail Your Minnesota Health Care Programs Claims
Submitting your paper claims to the correct Minnesota Health Care Programs claims address is the final, critical step in the process. Ensure you mail all paper claims, including any necessary attachments, to the following address:
Minnesota Department of Human Services
MHCP Claims Processing
PO Box 64993
St Paul, MN 55164-0993
By adhering to these guidelines and using the correct claims address, providers can facilitate the efficient processing of their paper claims by Minnesota Health Care Programs. Remember to always verify the most current policies and address directly from the official MHCP website to stay updated with any changes.
