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MN WC E-Billing

MN WC E-Billing

The following is important electronic medical billing and contact information to help facilitate successful electronic data interchange. (EDI) per Minnesota Statute, 176.135 Section 1 (a)

Payer Identification Number

(13021) The Payer ID Number is an assigned number by our eBill agent, Jopari Solutions. If you use another eBill agent other than Jopari Solutions, then it is recommeneded you verify with your vendor the assigned payer ID number for bill submission to ensure proper EDI routing. Consideration: if there are multiple associated payer IDs, rules must be clear when posting IDs to mitigate misrouting and potential PHI breach exposure.

How to report the Payer Identification Number in the 5010 ASCX12 837 TR3

Payer Identification number is populated in the 5010 ASCX12 837 TR3 as follows:
Loop 2010BB Payer Name
NM108 = PI (qualifier)
NM109 = xxxxxxx
Reference Source: 5010 ASCX12 837 TR3 Implementation Guide available at http://www.wpc-edi.com

Clearinghouse Contact Information

Jopari Solutions
Corporate Office:
Suite 500, 1855 Gateway Boulevard
Concord, CA 94520
eBill Enrollment and Customer Care Contact Information:
Phone: 800-630-3060, option 3
Email: www.jopari.com/contact-us

Payer Contact Information

UFG - James Sharman
118 Second Ave SE
Cedar Rapids, IA 52401
Phone: 800-343-9131 option 3
Email: helpdesk@unitedfiregroup.com

How to report a Claim Number in the 5010 ASCX12 8367 TR3

Claim Number:Claim identification number is reported in the 5010 ASCX12 837 TR3 as follows:
Loop 2010 CA Patient Name
REF Segments= Property and Casualty Claim Number
REF01 = Y4 (qualifier)
REF02 = Claim Number (10 digits)
Reference Source: 5010 ASCX12 837 TR3 Implentation Guide available at http://www.wpc-edi.com

Payer identification number is populated in the 5010 ASCX12 836 as follows:
Loop 2010BB Payer Name
NM108 = PI (qualifier)
NM109 = Payer ID number
Reference Source: 5010 ASCX12 837 TR3 Implentation Guide available at http://www.wpc-edi.com