Remittance Delivery: Delivery pathway is going to vary and will require clearinghouse level enrollment, please contact us for help if you have trouble getting it working!
Enrollment Instructions:
Please complete Availity’s Multi-payer enrollment form prior to visiting the payer’s site and completing ERA enrollment with the payer. Once on the payer's site, complete the ‘Submitter Information’ with the following: Submitter ID (UMPI) - A268453200; Submitter Name – Availity LLC; Address – 740 E Campbell Rd, Suite 1000, Richardson, TX 75081; Phone – 800.282.4548
EDI Submitter Enrollment Form https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4087-ENG Once on the payer's site, complete the ‘Submitter Information’ with the following: Submitter ID (UMPI) - A268453200; Submitter Name – Availity LLC; Address – 740 E Campbell Rd, Suite 1000, Richardson, TX 75081; Phone – 800.282.4548
Additional Instructions:
DPWMN_MEDICAID MINNESOTA_835.837.032023.pdf
DPWMN_MEDICAID MINNESOTA_835.837.032023.pdf