State · MN
Medical billing services in Minnesota
Short answer
Medical billing services in Minnesota answer to a deadline most states do not have: Minn. Stat. 62Q.75 gives a provider six months from the date of service to submit charges to a health plan company or third-party administrator, and a charge that misses it cannot be collected from the plan or the patient.
The same section makes those payers pay or deny a clean claim within 30 calendar days or owe 1.5 percent interest a month. Fee-for-service MHCP claims go through MN-ITS within 12 months, about 83 percent of Medicaid enrollees sit in a prepaid plan, and every claim has had to be electronic since 2009. A Remitwright dedicated biller keeps those clocks, serving Minnesota practices remotely. Rules for other states are on the medical billing services by state page.
Last reviewed by the Remitwright billing team. Editorial policy
Billing in Minnesota: what's different
The rules below change how a claim is filed and paid in Minnesota. Each line links to the official page it was read from, and the date at the top of this page is when it was last checked.
| Fact | In Minnesota | Source |
|---|---|---|
| Medicaid program | Minnesota Health Care Programs (Medical Assistance)Minnesota Department of Human Services (DHS) | 1 |
| Fee-for-service portal | MN-ITS | 1 |
| Managed care plans | 9 plansBlue Plus, HealthPartners, Hennepin Health, Itasca Medical Care, Medica, PrimeWest Health, South Country Health Alliance, UCare, UnitedHealthcare of Minnesota | 6 |
| Medicaid timely filing (fee-for-service) | 12 months after the date of service | 2 |
| Prompt-pay law | Minn. Stat. 62Q.75, prompt payment of claims | 3 |
| EVV | Open model under Minn. Stat. 256B.073 | 8 |
Minnesota Health Care Programs (Medical Assistance)
Minnesota Health Care Programs (Medical Assistance) is run by the Minnesota Department of Human Services (DHS). Fee-for-service claims and provider enrollment go through MN-ITS1, at www.dhs.state.mn.us. About 83 percent of Minnesota Medicaid enrollees (1,003,639 of 1,204,793 in 2024) were in a full-benefit prepaid plan under four programs: Prepaid Medical Assistance Plan Plus, Minnesota Senior Health Option, Minnesota Senior Care Plus and Special Needs Basic Care5. CMS managed care enrollment data for 2024; the plan list below comes from the same CMS report. The programs run as a demonstration under Minn. Stat. 256B.69, which has the commissioner contract each year with demonstration providers, including county boards, to deliver prepaid services.
Fee-for-service filing limit: 12 months after the date of service for the claim to reach the department; a request to adjust a payment is due within six months after the payment date2. Minnesota Rules 9505.0450: the department has no obligation to pay a claim submitted late. A six-month window applies instead after a Medicare determination, a court order, an erroneous eligibility determination or an erroneous rejection. Prepaid plans follow their contracts, and the six-month charge deadline in Minn. Stat. 62Q.75 applies to any health plan company.
Managed care plans6
- Blue PlusPrepaid Medical Assistance Plan Plus, Minnesota Senior Health Option and Minnesota Senior Care Plus
- HealthPartnersAll four programs, including Special Needs Basic Care
- Hennepin HealthPrepaid Medical Assistance Plan Plus and Special Needs Basic Care
- Itasca Medical CarePrepaid Medical Assistance Plan Plus, Minnesota Senior Health Option and Minnesota Senior Care Plus
- MedicaAll four programs
- PrimeWest HealthAll four programs
- South Country Health AllianceAll four programs
- UCareAll four programs; the largest Prepaid Medical Assistance Plan Plus enrollment in 2024
- UnitedHealthcare of MinnesotaPrepaid Medical Assistance Plan Plus, Minnesota Senior Health Option and Special Needs Basic Care
Each plan is credentialed separately, has its own portal and its own appeal route. A practice that joins Minnesota Medicaid through one plan is not in network with the others until each contract is in place.
Commercial payers and the prompt-pay law
Commercial payers active in Minnesota10: Blue Plus, HealthPartners Inc. and HealthPartners Insurance Corporation, Medica Insurance Company, Quartz Health Plan MN Corporation, Aspirus Health Plan. A Minnesota practice works to a separate provider manual for each, with its own filing window, corrected-claim process and appeal levels. Verified payer deadlines, each with its source, are in the timely filing limits table.
Clean-claim payment window under Minn. Stat. 62Q.75, prompt payment of claims: 30 calendar days to pay or deny a clean claim, with interest of 1.5 percent per month or part of a month on a late payment3. The section applies to health plan companies and third-party administrators. Subdivision 3 cuts the other way: a provider has six months after the date of service, or after the date it learned the correct payer name and address, to submit the charge, and a charge submitted late cannot be collected from the plan, the patient or any other payer. Where the statute earns its place is A/R follow-up: a clean claim that outlasts the window is escalated with the statute cited, and interest is requested where Minnesota law provides it.
NEMT and home care in Minnesota
Non-emergency medical transportation. Fee-for-service rides run through an administrative agency that applies the commissioner's level-of-service process and pays enrolled NEMT providers; covered modes range from client mileage reimbursement and volunteer drivers to unassisted taxi or transit trips, assisted transport and lift-equipped or ramp vehicles, and every driver must be individually enrolled with the commissioner and reported on the claim as the person who provided the service7. Minn. Stat. 256B.0625, subd. 17. Providers must take the most direct route and may not exceed 30 miles to a primary care provider or 60 miles to a specialist without authorization, must keep trip logs with pickup and drop-off times signed by the medical provider or the client, and may not bill a second base rate to continue a trip past the original destination. A client who requests mileage reimbursement signs the trip log. The NEMT billing in Minnesota page covers trip documentation, broker claims and reconciliation.
Electronic visit verification. Open model under Minn. Stat. 256B.073: a provider may use the state-provided EVV system, which must be available at no cost, or a third-party system that meets the DHS technical and data-submission requirements, and EVV covers personal care assistance, community first services and supports, home health, adult day and companion services, ARMHS, assertive community treatment, EIDBI, integrated community supports, nonemergency medical transportation, recovery peer support and hourly waiver services8. House Research reports EVV phased in from June 2022 for personal care assistance and home health and expanded to the other services in July 2026; DHS must publish the state vendor's name, use EVV data to validate claims, and require managed care plans to make EVV and claims systems interoperable by January 1, 2027. CMS lists Minnesota as compliant for home health EVV as of January 1, 2024. See home care billing in Minnesota for waiver programs, EVV exceptions and authorizations.
Rules that change how Minnesota claims are billed
Six months to submit a charge, or it cannot be billed to anyone3
Minn. Stat. 62Q.75, subd. 3 gives health care providers and facilities six months, counted from the date of service or from the date the provider knew or was told the correct name and address of the payer, to submit their charges to a health plan company or third-party administrator. A provider that misses the deadline is not reimbursed for the charge and may not collect it from the recipient of the service or any other payer. That is tighter than most payer contracts, so the first-pass clean claim rate decides whether revenue survives.
Every claim has gone electronic since July 15, 200911
Minn. Stat. 62J.536 requires all health care providers to submit the HIPAA claim or encounter transaction electronically to group purchasers, which must accept it, using single, uniform companion guides that the commissioner of health bases on Medicare standards. Since January 1, 2012 the receiver must also return a standard electronic acknowledgment (TA1, 999 or 277CA). For Minnesota Health Care Programs that means MN-ITS or a clearinghouse for claims, claim status and the remittance advice.
Prepaid Medicaid plans owe a clean claim within 30 business days4
Under Minn. Stat. 256B.69, subd. 6, a demonstration provider that contracts with practitioners to serve its enrollees must pay a clean claim, as defined in 42 CFR 447.45(b), within 30 business days of the date it accepts the claim. The demonstration itself exists to test whether prepayment plus care management delivers coordinated care while containing cost, and the commissioner contracts annually with nonprofit plans, accountable networks and county boards to run it.
Telehealth pays like an in-person visit, audio-only through July 1, 20277
Minn. Stat. 256B.0625, subd. 3b covers medically necessary services and consultations delivered through telehealth in the same manner as if they had been delivered in person. Telehealth means real-time two-way interactive audio and visual communication or an accessible video-based platform, and from July 1, 2025 through July 1, 2027 audio-only communication between the provider and the patient also qualifies, so the modality on the claim has to match a date-sensitive definition.
EVV expanded beyond personal care and home health in July 20269
EVV arrived in Minnesota in a phased rollout that began in June 2022 for personal care assistance and home health, and in July 2026 the legislature expanded it to community first services and supports, adult day, adult companion, ARMHS, assertive community treatment, EIDBI, integrated community supports, nonemergency medical transportation, recovery peer support and hourly waiver services. The state-provided system vendor must offer the free state system before any fee-based product, a third-party vendor must report any data transmission failure immediately, and the data collected feeds the commissioner's claim validation.
Services for Minnesota practices
Remitwright serves Minnesota practices remotely, inside the practice management or EHR system the practice already uses. A dedicated biller works the account; nothing is pooled. Each service below explains what that biller does.
- Medical billingClaims worked by one named biller
- CredentialingEnrollment, CAQH and PECOS kept current
- Eligibility verificationCoverage and benefits checked before visits
- Prior authorizationAuths requested, tracked, attached to claims
- Denial managementEvery denial read, worked and appealed
- A/R follow-upUnpaid claims chased before filing limits
FAQ
Questions from Minnesota practices
What is the Minnesota Medicaid timely filing limit?
Does the six-month rule in Minn. Stat. 62Q.75 apply to our claims?
How fast must a Minnesota health plan pay a clean claim?
Which plans run Medicaid managed care in Minnesota?
Which services need EVV in Minnesota, and can we use our own system?
Who arranges NEMT rides for Medicaid members in Minnesota?
Can we still send paper claims in Minnesota?
Which commercial payers did you list for Minnesota, and why those?
Next step
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