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Use MN–ITS Request Claim Status (276/277) to Copy, Void or Replace a Claim

Revised: 04-07-2015

The new MN–ITS Request Claim Status response page allows you to check the status on all claims submitted through MN–ITS DDE, X-12 Batch including Medicare Crossovers or claims received from Billing Organizations, Pharmacy Prescriptions and internal adjustment claims.

Claims submitted through MN–ITS (DDE) are now accessible on the same day using the MN–ITS Request Claim Status (276) feature.

Limitations:

Claims over one year old are subject to timely billing requirements and may not be eligible for reimbursement Claims over three years old cannot be viewed

Refer to the MHCP Provider Manual Billing Policy Replacement and Void Claims section for additional situations that require separate instructions.

Note: The claim retrieval process does not return all data fields. Providers need to verify that their claim contains all of the required information. Providers may need to reenter the appropriate information before submitting a claim that was copied, replaced or voided.

The following fields are returned with a defaulted response or blank:

Claim

Screen

Field Section and/or Field Name

Default or Blank

837D
837P

Claim Information

Place of Service (POS)

Defaults POS on 1st service line

837D
837P
837I

Claim Information

Assignment/Plan Participation, Benefits Assignment, Release of Information and Provider Indicator

Defaults standard response

837P

Situational Claim Information

Property and Casualty: Contact Name, Telephone Number and Extension

Blank

837P

Situational Claim Information

Situational Ambulance Information: Certification Condition, Condition Code, Patient Weight, Transport Distance, Transport Reason Code, Round Trip Purpose Description and Stretcher Purpose Description

For claims originally submitted before March 15, 2015, these fields will return blank.

For claims originally submitted on or after March 15, 2015, these fields will be returned as they were submitted on the claim.

837I

Situational Claim Information

Claim Notes Reference

UPI

837I

Situational (Continued) Claim Information

Auto Accident State or Province, Delay Reason

Blank

837P

Situational Claim Information

EPSDT: Certification (child and teen checkups)

Y

837D
837D
837P
837I

COB

Other Payer Subscriber: Relationship Code

18

837D
837P
837I

Services – Other Payer

Paid Unit Count

1

837P
837I

Services – Situational Services

NDC Information – Code Qualifier

UN

837D

Services – Situational Services

Prosthesis Information: Prosthesis Code, Prior Placement Date, Orthodontic Banding Date and Replacement Date

Blank

837P

Services – Other Providers

Ordering Provider and Referring Provider

For claims originally submitted before March 15, 2015, these fields will return blank.

For claims originally submitted on or after March 15, 2015, these fields will be returned as they were submitted on the claim.

Log in to MN–ITS

  • 1. Log in to MN–ITS
  • 2. From the left menu:
  • a) Select MN–ITS
  • b) Select Request Claim Status (276)
  • Using MN–ITS Request Claim Status Response (276)

  • 1. In the Quick Search section, enter the following required fields:
  • a. Enter the 8-digit MHCP recipient number in the Subscriber ID field.
  • b. Enter the first date of service of your claim in the Service Date (From) field using MMDDYYYY format.
  • 2. To search for a span of dates, enter the end date of service in the Service Date (To) field using MMDDYYYY format. Shortening the date span will narrow your search results.
  • 3. (Billing Organizations Use Only) Billing Agent, Billing Intermediary or Consolidated Billing Entity are required to enter the pay-to provider’s 10-digit NPI/UMPI for the claim you are requesting in the Pay-to-Provider field to receive a valid response.
  • 4. In the Detail Search section, providers may enter one of the following optional fields to narrow search results:
  • a. Enter the 17-digit payer claim control number in the Payer Claim Control Number (PCN) field.
  • b. Enter the12-digit pharmacy prescription number in the Pharmacy Prescription Number field.
  • 5. Use the Action buttons to complete or cancel your request:
  • a. Select Submit to view your Claim Status Response (277). (You may briefly see a message stating: Your claim is processing. Please wait.)
  • b. Select Close to cancel your request and return to the MN–ITS Home Page
  • Using MN–ITS Request Claim Status Response (277) to Copy a Claim

    Providers can use the copy feature if the claim that was just submitted contains some or all of the information needed to submit a new claim.

  • 1. From the Request Claim Status Response, select the Copy action button to retrieve an exact copy of the claim that was just entered.
  • 2. On the Provider Screen, select Continue.
  • 3. If the claim is for a different subscriber, select Delete, enter the Subscriber ID and Birthdate, and select Search. If not, select Continue.
  • 4. On the remaining screens complete the required (*) fields or appropriate situational field(s) (**) on each screen. Select the appropriate closed Accordion Panels or Continue to advance to the next screen.
  • Note: Refer to the appropriate 837 MN–ITS User Guide, and the specific service section of the MHCP Provider Manual, for billing information and instructions on how to complete your specific claim type.

  • 5. Select the Validate button to ensure you have completed all required fields. Your claim information will be submitted and returned to you with the appropriate edits. To determine if corrections need to be made, review the Claim Status Category and Claim Status codes using the Washington Publishing Company link on the right side of the screen.
  • 6. Select the Submit button to submit the claim. Within seconds, you will receive a Claim Response, similar to the Validate Response, with the claims Control number (in orange) at the top.
  • For more information on your submit response, refer to Understanding Your Claim Status Response (277).

    Using MN–ITS Request Claim Status Response (277) to Replace a Claim

    If a claim is denied, or has missing or incorrect information, you may replace the claim, making any necessary corrections. Replacing a claim will reverse the entire payment from each line item. Include all service lines that are valid for the corrected claim. Remember to select Validate to ensure your claim will be submitted correctly.

  • 1. From the Request Claim Status Response, select the Replace action button to retrieve an exact copy of the claim that was just entered.
  • 2. On the Provider Screen, select Continue.
  • 3. If the claim is for a different subscriber, select Delete, enter the Subscriber ID and Birthdate, and select Search. If not, select Continue.
  • 4. On the Claim Information Screen, the Replacement Claim Frequency Code radio button is selected and the Payer Claim Control Number is auto-populated.
  • 5. On the remaining screens, complete the required (*) fields or appropriate situational field(s) (**) on each screen. Select the appropriate closed Accordion Panels or Continue to advance to the next screen.
  • Note: Refer to the appropriate 837 MN–ITS User Guide, and the specific service section of the MHCP Provider Manual, for billing information and instructions on how to complete your specific claim type.

  • 6. Select the Validate button to ensure you have completed all required fields. Your claim information will be submitted and returned to you with the appropriate edits. Review the Claim Status Category and Claim Status codes using the Washington Publishing Company link on the right side of the screen to determine if corrections need to be made.
  • 7. Select the Submit button to submit the claim. Within seconds, you will receive a Claim Response similar to the Validate Response with the claims Control number (in orange) at the top.
  • For more information on your submit response, refer to Understanding Your Claim Status Response (277).

    Using MN–ITS Request Claim Status Response (277) to Void a Claim

    Providers have the option to Void a claim. This option lets providers cancel a paid claim that may have been submitted in error. Providers can also cancel a claim requiring changes to the pay-to provider or claim type. You do not need to validate when submitting a void claim.

  • 1. From the Request Claim Status Response, select the Void action button to retrieve an exact copy of the claim that was just entered.
  • 2. On the Provider Screen, select Continue.
  • 3. If the claim is for a different subscriber, select Delete, enter the Subscriber ID and Birthdate, and select Search. If not, select Continue.
  • 4. On the Claim Information Screen, the Replacement Claim Frequency Code radio button is selected and the Payer Claim Control Number is auto-populated.
  • 5. On the remaining screens complete the required (*) fields or appropriate situational field(s) (**) on each screen. Select the appropriate closed Accordion Panels or Continue to advance to the next screen.
  • Note: Refer to the appropriate 837 MN–ITS User Guide, and the specific service section of the MHCP Provider Manual, for billing information and instructions on how to complete your specific claim type.

  • 6. Select the Validate button to ensure you have completed all required fields. Your claim information will be submitted and returned to you with the appropriate edits. Review the Claim Status Category and Claim Status codes using the Washington Publishing Company link on the right side of the screen to determine if corrections need to be made.
  • 7. Select the Submit button to submit the claim. Within seconds, you will receive a Claim Response similar to the Validate Response with the claims Control number (in orange) at the top.
  • For more information on your submit response, refer to Understanding Your Claim Status Response (277).

    Understanding Your Claim Status Response (277)

    The 277 Claim Status Response contains the current status of your claim and provides the Remittance Advice date if the claim has been paid or denied.

    The claim response displays the Claim Information and the first Service Line on the claim, along with the WPC HIPAA compliant Claim Status Category and Claim Status codes that explain how the claim and the first line were processed.

    If there are additional service lines, they are displayed as a blue collapsed accordion panel with the line number and a general service summary. To understand how the entire claim was processed, providers must select each line to review the HIPAA compliant codes and payment information.

    Providers may print a copy of the response by selecting the Print Page link in the upper right section of the response.

    After printing is complete, select Back to 277 Response. If you need additional changes, select the appropriate action button or select close to return to the MN–ITS Home page.

    Action Buttons

    Copy To correct an error of a denied claim or to copy information from other similar claims previously submitted.

    Replace If the claim paid, but paid incorrectly or a line item was denied. You may access the claim, correct the information and resubmit. The original paid amount will be taken back and replaced with the correct information on the replacement claim.

    Void – If the claim was submitted in error. This deletes the claim and takes the payment back.

    Close returns you to the MN–ITS Home Page.

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    © 2017 Minnesota Department of Human Services Updated: 4/7/15 2:40 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 4/7/15 2:40 PM