Data Issues Workgroup
The Data Issues Workgroup documents and standardizes the edits, data validation, and usage of
data within the HIPAA transactions. This will simplify the implementation
of the required transactions and minimize the duplication of effort.
The workgroup will create community
companion guides for the transactions that will identify and document
Collaborative member payer and provider specific edits. This includes data segments and
elements (required/needed vs. not needed), edits and data validation,
common use and variation of loops, segments, elements, and codes.
Transaction companion guides tab
New Minnesota Law for Health Care Billing Transactions*
What:
Effective in 2009, Minnesota Statues (section 62j.536) require all health care providers and group purchasers (payers, plans) to exchange eligibility inquiries and responses, claim, and remittance advices electronically, using a standard format.
How:
The Minnesota Department of Health (MDH) is consulting with Minnesota's Administrative Uniformity Committee (or AUC, the broad-based group of providers and payers listed below) to develop uniform standard companion guides for these transactions. Providers will be able to use these guides to standardize the way they check eligibility, submit claims, and receive remittance advice in the electronic format for all Minnesota health payers. Payer/group purchaser will use these guides to plan for, program and accommodate these electronic transactions. Visit the AUC website (at the URL below) and MDH online at www.health.state.mn.us/asa to learn more.
* For more information on the MN Administrative Uniformity Committee (AUC) go to www.health.state.mn.us/auc/index.html
Work Products
Prior to January 1, 2012, the guides may be used by mutual trading partner agreement following adoption of applicable v5010 Minnesota Companion Guide Rules into rule;
Required for Use beginning January 1, 2012
Transaction |
Link |
005010X222A1 - 837 Professional Claim |
www.health.state.mn.us/asa |
005010X223A2 - 837 Institutional Claim |
005010X224A2 – 837 Dental Claim |
005010X221A1 - 835 Claims Payment Advice |
005010X279A1 - 270/271 Eligibility Benefit Inquiry and Response |
NCPDP D.0 – Pharmacy Claims Submission and Response |
NCPDP D.0 – Pharmacy Claims Reversal and Response |
005010X231 - 999 Acknowledgement for Health Care Insurance |
005010X231 – TA1 Acknowledgement for Health Care Insurance, Interchange Acknowledgement Segment |
005010X214E2 - 277 Health Care Claim Acknowledgement |
(Some of these documents are .PDF files; you will need Adobe® Acrobat® Reader, a free utility, to view. If you do not have Adobe® Acrobat® Reader, please click here to download.)
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