2004 Minnesota Statutes

     62J.58 Implementation of standard transaction sets. 

    Subdivision 1.    Claims payment.  Six months from the 
 date the commissioner formally recommends the use of guides to 
 implement core transaction sets pursuant to section 62J.56, 
 subdivision 3, all category I industry participants and all 
 category II industry participants, except pharmacists, shall be 
 able to submit or accept, as appropriate, the ANSI ASC X12 835 
 health care claim payment/advice transaction set (draft standard 
 for trial use version/release 3051) for electronic submission of 
 payment information to health care providers. 

    Subd. 2.    Claims submission.  Six months from the date 
 the commissioner formally recommends the use of guides to 
 implement core transaction sets pursuant to section 62J.56, 
 subdivision 3, all category I and category II industry 
 participants, except pharmacists, shall be able to accept or 
 submit, as appropriate, the ANSI ASC X12 837 health care claim 
 transaction set (draft standard for trial use version/release 
 3051) for the electronic transfer of health care claim 
 information.  

    Subd. 2a.    Claim status information.  Six months from 
 the date the commissioner formally recommends the use of guides 
 to implement core transaction sets under section 62J.56, 
 subdivision 3, all category I and II industry participants, 
 excluding pharmacists, may accept or submit the ANSI ASC X12 
 276/277 health care claim status transaction set (draft standard 
 for trial use version/release 3051) for the electronic transfer 
 of health care claim status information. 

    Subd. 3.    Enrollment information.  Six months from the 
 date the commissioner formally recommends the use of guides to 
 implement core transaction sets pursuant to section 62J.56, 
 subdivision 3, all category I and category II industry 
 participants, excluding pharmacists, shall be able to accept or 
 submit, as appropriate, the ANSI ASC X12 834 health care 
 enrollment transaction set (draft standard for trial use 
 version/release 3051) for the electronic transfer of enrollment 
 and health benefit information.  

    Subd. 4.    Eligibility information.  Six months from 
 the date the commissioner formally recommends the use of guides 
 to implement core transaction sets pursuant to section 62J.56, 
 subdivision 3, all category I and category II industry 
 participants, except pharmacists, shall be able to accept or 
 submit, as appropriate, the ANSI ASC X12 270/271 health care 
 eligibility transaction set (draft standard for trial use 
 version/release 3051) for the electronic transfer of health 
 benefit eligibility information.  

    Subd. 5.    Applicability.  This section does not 
 require a group purchaser, health care provider, or employer to 
 use electronic data interchange or to have the capability to do 
 so.  This section applies only to the extent that a group 
 purchaser, health care provider, or employer chooses to use 
 electronic data interchange. 

    HIST: 1994 c 625 art 9 s 9; 1995 c 234 art 5 s 19; 1996 c 440 
 art 1 s 30