MHCP Enrolled Providers

Electronic Claim Attachments

Requirements for claim attachment submission have been standardized across Minnesota for E3. MHCP requires only a limited number of claim attachments. Claims with attachments are complex claims for prompt payment purposes. Do not send paper claims with attachments.

When you need to submit an electronic claim with an attachment, follow these steps:

  • 1. Review the MHCP Attachment Criteria to ensure that your claim attachment is necessary
  • 2. Complete the AUC Cover Sheet for Health Care Claims (required for all attachments across MN). Do not use the AUC Appeals Cover Sheet. Use the AUC Uniform Cover Sheet only for electronic claims that require an attachment. Do not use the AUC Uniform Cover Sheet without an attachment control number (ACN) or to submit authorization requests that require attachments
  • • Create a unique ACN (ACN must be unique to each claim and not patient account number unless patient has new account number each visit;
  • • Enter the appropriate ACN (including spaces/hyphens) on each attachment page (each type of attachment must have its own completed Cover Sheet), the Cover Sheet and your electronic claim
  • Interactive: Enter the ACN(s) in the Claim Information tab, Attachment Control Number/PWK field; select the qualifier in the type field
  • Batch: Enter the ACN(s) in Loop 2300, PWK06; enter the attachment type in Loop 2300, PWK01; enter the method by which you send the attachment information in Loop 2300, PWK02 (follow complete AUC Attachment Cover Sheet Instructions)
  • 3. Submit the claim electronically via MN–ITS Interactive or Batch
  • 4. Fax the Cover Sheet and attachment(s) to MHCP at 651-431-7786
  • Providers must send the attachment by end of next business day after submitting the electronic claim.

    MHCP will deny claims for lack of an attachment after three business days of receipt of the claim.

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