Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
Administrative Simplification
Introduction Minnesota Statute 62J.536, requires health care providers and
group purchasers (payers, health plans) to exchange eligibility
requests, claims and remittances electronically using standard
formats. The intent of the law is to reduce costs, simplify and
speed up health care transactions, and to give providers and health
plans one set of rules to follow for electronic transactions. This
statute applies to all health care providers in Minnesota, regardless
of participating status.
Web-based Claim
Submission, Eligibility,
and Remittance Tool
Pharmacy and Dental
Claims
Blue Cross and Blue Shield of Minnesota (Blue Cross) offers a nocost,
web-based tool through Availity to comply with the
Minnesota Statute 62J.536. Availity, an independent company,
also provides no-cost solutions to obtain eligibility and benefits as
well as viewing your remittance information. Availity, an
independent company, is a one stop shop that optimizes
information exchange between multiple heath care stakeholders
through a single secure network. Providers may also take
advantage of a range of optional, value-added services for a
nominal cost. For more information contact Availity at
availity.com to register for their no-cost web-based tools.
The requirement to submit all claims electronically includes dental
and pharmacy formatted claim types. Blue Cross is completing
system changes to accept and properly adjudicate these electronic
claim types. Due to the complexity of the changes and need for
extensive testing, Blue Cross can not accept dental formatted or
pharmacy formatted electronic claims at this time. Pharmacy and
dental providers should continue to submit these claim types on
paper until notified by Blue Cross.
8-4 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12)