Minnesota electronic billing requirements
Information for medical providers
Minnesota SB2193 requires workers’ compensation carriers to provide the following information to Minnesota workers’ compensation providers effective Jan. 1, 2016.
Payer information
Sentry Insurance
1800 North Point Drive
P.O. Box 8032
Stevens Point, WI 54481
800-473-6879
sentry.com
Clearinghouse information
Medical and dental bills
Sentry Insurance Company, its affiliates, and subsidiaries (“Sentry Insurance”), partner with Jopari to process medical and dental invoices submitted electronically.
Clearinghouse information—medical and dental bills
Jopari
Suite 500, 1855 Gateway Boulevard
Concord, CA 94520
Customer care: 800-630-3060
eBill enrollment: 866-269-0554
support@jopari.com
jopari.com
Payer ID: J1417
The payer ID number is populated in the 5010 ASCX12 837 TRs as follows:
Loop 2010BB Payer Name
NM108-PI (qualifier)
NM109=Payer ID number.
Reference Source: 5010 ASCX12 837 TR3
Implementation guide available at wpc-edi.com
Claim identification
Medical and dental providers may contact Sentry Insurance at 800-473-6879, select option 1 (claims), and then option 3 (existing claim) for validation of claim numbers.
Medical providers contracted with Jopari may use the Jopari Provider Portal at jopari.com or contact Sentry Insurance at 800-473-6879, select option 1 (claims), and then option 3 (existing claim) for validation of claim numbers.
Invoice submission
Claim identification number is reported in the 5010 ASC X12 837 TRs as follows:
Loop 2010 CA Patient Name
REF Segments=Property and Casualty Claim Number
REF01=Y4 (qualifier)
REF02+Claim Number
Reference Source: 5010 ASCX12 837 TR3
Implementation guide available at wpc-edi.com
Pharmacy bills
Sentry Insurance Company, its affiliates, and subsidiaries (“Sentry Insurance”) partner with Optum to process pharmacy invoices submitted electronically.
Clearinghouse information—pharmacy bills
Optum
11000 Optum Circle
Eden Prairie, MN 55344
877-470-9572
helpdesk3@optum.com
www.workcompauto.optum.com
Payer ID: Optum (PBM) BIN 004261
Optum (PBM) PCN CAL
Claim identification
Pharmacy providers may contact Sentry Insurance at 800-4SENTRY (800-473-6879), select option 1 (claims), and then option 3 (existing claim) for validation of claim numbers.
