Minnesota (Medicaid) - Quick Reference, What You Need to Know...
Search Options
-
Basically, there are no changes in search options. This payer supports
the following search options.
The Middle Initial is optional on the 3rd and 4th search options.
1. Recipient ID and Date of
Birth.
2. Social Security Number and Date of Birth.
3. Social Security Number, Last Name, First Name, and Middle Initial.
4. Last Name, First Name, Middle Initial, and Date of Birth.
- For
successful transaction processing, dependent data may be promoted to the
subscriber loop.
-
Previously, this payer required the Provider’s Taxonomy Code, Street
Address, City, State, and Zip Code.
This is no longer required.
Dates
-
Basically, there are no changes in dates.
This payer uses a single begin date for an inquiry.
-
This payer supports up to one year in the
past. No future dates or date spans are allowed.
-
Inquiry dates now reference a Plan Date –
291 (DTP01).
Response Data
Benefits
The following information is based on a
generic “Health Benefit Plan Coverage - 30” inquiry.
-
Basically, no substantial difference was observed between the 4010
and the 5010 271 response.
-
The
5010 response now uses service type codes for Mental Health – MH,
and Urgent Care – UC.
-
The
response includes the Monthly Family Deductible with a Message
Segment.
Disclaimer
This document is not intended to identify every scenario that may be
presented in the payer response.
It should
also be noted, that the payer response may vary depending on the search
criteria used in the initial inquiry.
Some content
is no longer returned in the X12 5010 271 response. In a similar fashion,
some content has been
modified and
new response information may be returned. Information that appeared
consistent between the
4010 and 5010
responses was not presented in this document.