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Paper Claim Submission Policies

Revised: 05-03-2010

MHCP accepts paper claims only from out-of-state providers who do not routinely bill MHCP. Out-of-state providers who routinely bill MHCP must bill electronically using MN–ITS.

Refer to the following additional resources:

  • How to Complete and Submit Paper MHCP Authorizations
  • MN–ITS User Guide
  • Remittance Advice Web page to read the RA
  • MHCP uses an optical character reader (OCR) to scan paper claims and authorization requests. The OCR can read most typed print; however, it cannot read marginal quality print. MHCP will return claims with marginal quality print to you. All paper claims must be typed or computer printed. Use the following guidelines to complete paper claim forms:

  • • Use original claim forms (ADA; CMS-1500; UB-04). MHCP does not accept faxed, copied, or screen
    printed invoices
  • • Use appropriate authorization request forms, as appropriate, complete all required information
  • • Properly align paper forms for printing/typing
  • • Do not write or mark outside the boxes
  • • Use only black ribbon or print
  • • Do not use bold, compressed, cubic, enlarged, italic, mixed or script typestyles or fonts. If using a
    typewriter, use pica (10 pitch) or elite (12 pitch)
  • • Capitalize all alpha characters
  • • Do not use symbols (#, $, &, @, !, %)
  • • Do not fold or staple paper claims
  • Claim Attachments

    Review MHCP Attachment Criteria to determine if you need to submit an attachment with the claim. MHCP will deny claims with attachments that are unnecessary.

  • • Use clean 8 ½ x 11-inch paper
  • • Paperclip all pages together with the claim; do not use staples.
  • Address

    Mail paper claims, including attachment, as appropriate, to:

    Minnesota Department of Human Services
    MHCP Claims Processing
    PO Box 64993
    St Paul MN 55164-0993

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