Submit an Authorization Request for Medical Services with Consolidated NPIs

Posted: September 14, 2022

Some Minnesota Health Care Programs (MHCP) services require authorization. Do not send authorization requests for services that do not require authorization. Refer to the Authorization section of the MHCP Provider Manual for authorization criteria and documentation requirements.

Using MN–ITS Interactive

· Complete all bolded and asterisked (required) fields. Field titles with an asterisk (*) indicate that the information is mandatory.

· Complete other nonbolded or nonasterisked field’s appropriate for your request

· Underlined items are linked to helpful webpages and include additional information about that item, including information about completing a field, code definitions for fields, or instructional information.

Submitting an Authorization Request

1. Log in to MN–ITS

2. Select MN–ITS from the left-hand menu

3. Select Authorization Request (278)

Completing the Authorization Tab

Authorization Category

Service Type Code: Select Medical from the drop-down menu.

Requester

1. Request ID (NPI/UMPI): The Organization or last name, first name, street address, city/town, state and ZIP code will auto-populate based on the NPI you used to log in. (The NPI/UMPI field identifies the individual organization that is requesting the service or item.)

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2. Click the LOOK UP button to choose a location and taxonomy code. Note: Not all providers will need to select a taxonomy. Only providers where the address information is the same will require a taxonomy to be selected.

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3. Click the blank circle next to the correct location and click the submit button to go to the Authorization main page.  

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4. Communication Number: Enter the telephone, fax number, (including area code) or email at which your contact can be reached. Click the A button to add the communication type. Click the A button if you need to add another communication number.

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5. Contact Name: Enter the first and last name of a contact person within your organization who can answer questions about this authorization request.

Subscriber

1. Subscribers ID: Enter the subscriber’s (member’s) 8-digit number from the subscriber’s (member’s) MHCP ID card.

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2. Birth Date: Enter 2-digit month, 2-digit day, and 4-digit year (MMDDYYYY) format. The birth date must match the birth date on the MHCP ID card.

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3. Last Name: Enter the subscriber’s (member’s) last name

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4. First Name: Enter the subscriber’s (member’s) first name.

Patient Event

1. Certification Type Code: Indicates what type of request. The default response is I (Initial) select the appropriate CT code.

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2. Diagnosis code: Enter the appropriate diagnosis code. Click the A button to add the diagnosis code. If you need to add another diagnosis code, click the A button.

Completing the Services Tab

Service Information

1. Begin Date: Enter the date you would like to begin providing services in MMDDYYYY format.

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2. End Date: Enter the date that you will complete these services in MMDDYYYY format in this field. You may leave this field blank if you are not sure of the end date.

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3. Procedure Code: Enter the appropriate procedure code.

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4. Modifiers: Enter modifiers in this field when necessary.

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5. Quantity: Enter the number of units you are requesting.

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6. Line Amount: Enter the total dollar amount (your usual and customary charge) you are billing for.

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7. Service Description: Enter a description of the service to be provided in this field, if needed. Note: This field has a 264-charater limit. You will not be able to enter any more text in this field after the limit is reached.

Service Setup

1. Scroll up to this heading and click the Save button to save the line item information you just entered.

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2. To add additional lines, click the New button to add an additional line and clear the fields on the screen.

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3. To delete a line, select the line, then click the Delete button.

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4. Repeat the steps until all line items are entered.

Submitting your Authorization Request for review

Click the Submit button. You will receive a response within seconds.

Authorization Request Responses

If your response states:	Then:
Transaction submitted successfully This request has been received for review by DHS.	Print the response page, keep a copy for your records and one to attach to the required documentation. Write the 11-digit number assigned on each page of your documentation, and the same 11-digit number on all supporting documentation pages that you be mailing or faxing to Kepro. Mail or fax all required supporting documentation together to the Medical review agent to assure accurate processing. Kepro Attention MN Medicaid 6802 Paragon Place, Suite 440 Richmond, VA 23230 Fax: 866-889-6512
This request is incomplete or invalid. The claim status codes below will provide additional information:	Refer to the Claim Status Codes available on the X12 website
Note: if after completing the Services Tab you receive the error message: “Denied incorrect payer,” verify eligibility using MN–ITS to confirm the subscriber (member) is not enrolled with a managed care organization (MCO).	· If the subscriber (member) is enrolled in an MCO, contact the MCO. · If the subscriber (member) is not enrolled in an MCO, contact the MHCP Provider Resource Center and verify the effective date of MCO coverage. For services completed before the effective date of the MCO coverage, use the actual date of service or a date before the MCO effective date

You will receive the final Authorization Letter in your MN–ITS Mailbox Miscellaneous Received file type: PAL after your Authorization Request is approved or denied.