MedStats Billing delivers end-to-end revenue cycle management built for Minnesota practices. We hold plans and third-party administrators to the 30-day clean claim rule in Minn. Stat. § 62Q.75, collect the 1.5% monthly interest that follows, block recoupments past the statutory 12-month deadline, manage no-fault PIP against a rigid $20,000 medical pool, and use mandatory arbitration on disputed balances.
Minnesota is a no-fault state with a hard 30-day payment clock, monthly compounding-scale interest and a statutory limit on how long a payer may reach back into a paid claim. Auto injury care is paid first from a rigid $20,000 medical pool that cannot be topped up from the wage-loss side, and disputes up to $10,000 go to mandatory no-fault arbitration rather than court. Work injury care is governed as much by treatment parameters as by the fee schedule. Every one of those rules is a deadline or a limit, and each of them is enforceable.
Minnesota Billing Specializations:
Prompt Payment Required (Minn. Stat. § 62Q.75) — Health plan companies and third-party administrators must pay or deny a clean claim within 30 calendar days after the date they received it. The obligation extends to third-party administrators, which matters for self-funded work routed through a TPA.
1.5% Monthly Interest — Where a clean claim is not paid or denied inside 30 days, interest runs from the day after the due date to the date of payment or denial at 1.5% per month or any part of a month, and must be paid to the provider at least quarterly. A payer may withhold interest only where payment was delayed to review potentially fraudulent or abusive billing.
The 12-Month Adjustment Deadline — Once a clean claim has been paid, the contract must impose a 12-month deadline on all adjustments and recoupments, excepting coordination of benefits, subrogation, duplicate claims, retroactive terminations and fraud or abuse. Offsets outside that window are contestable on the face of the statute.
Pattern Enforcement — The commissioner may assess an administrative penalty against a health plan company where there is a pattern of abuse showing a lack of good faith and a systematic failure to comply. Documented claim-level evidence is what turns a nuisance into a regulatory exposure.
No-Fault Basic Economic Loss (§§ 65B.44 et seq.) — Every Minnesota policy carries at least $40,000 per person per accident, split $20,000 for medical expenses and $20,000 for wage loss and replacement services. The split is rigid: unused non-medical dollars cannot be moved into the medical pool, so the medical limit is the real ceiling on auto injury care.
PIP Priority & Exhaustion — No-fault benefits pay first, regardless of fault, and health coverage or liability recovery only comes into play once benefits are exhausted or the statutory threshold is met. Tracking the remaining medical balance during a course of treatment is what prevents care being delivered with no payer behind it.
Mandatory No-Fault Arbitration — Claims for no-fault benefits of $10,000 or less at the commencement of arbitration go to mandatory arbitration under the Minnesota No-Fault Arbitration Rules, and the arbitrator retains jurisdiction over amounts that continue to accrue after the petition is filed. That is a real, fast route for a reduced or denied PIP balance.
Workers’ Compensation Treatment Parameters — Minnesota governs work injury care through treatment parameters as well as a medical fee schedule updated annually, so a denial is often about duration or frequency rather than price. Documentation against the parameters, and departure requests where care exceeds them, protect the balance.
Medical Assistance & MinnesotaCare Managed Care — Public programme members are served by health plans including Blue Plus, HealthPartners, Hennepin Health, Medica and UCare, alongside county-based purchasing organizations such as PrimeWest Health, South Country Health Alliance and Itasca Medical Care, each with its own submission and authorization rules.
Major Minnesota Payers — Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, UCare, Aetna, Cigna and UnitedHealthcare denial workflows.
Built to bring clarity, control and consistency to your Minnesota practice’s revenue cycle.
MedStats Billing manages the complete revenue cycle for Minnesota providers — from MN–ITS enrollment and health plan credentialing, through coding, claim scrubbing and submission, to denial resolution, interest recovery, no-fault arbitration petitions and workers’ compensation treatment parameter documentation.
Certified CPT, ICD-10-CM, and HCPCS coding with pre-submission claim scrubbing built around each payer's edits, so claims pay on the first pass. We manage charge entry, claim submission, payment posting, and insurance follow-up.
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Enrollment with Medicaid managed care plans, Medicare via PECOS, and commercial payers — plus CAQH maintenance and re-credentialing deadline tracking, so your providers stay in-network and billable without gaps.
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Coverage confirmed before the visit — active policy status, deductibles, co-pays, plan type, and prior authorization requirements — so front-end denials are caught while there is still time to fix them.
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Aged claims worked by payer and denial reason, with appeals filed inside each plan's window. We monitor outstanding balances, manage rejections, and drive down days in A/R to protect cash flow.
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A detailed review of coding accuracy, documentation standards, and denial patterns that identifies revenue leakage and compliance exposure — before a payer audit finds it for you.
Explore serviceLocal SEO, Google Business Profile optimization, and reputation management built for medical practices — helping the patients already searching for your specialty find you first.
Explore serviceMinnesota practices lose most of their recoverable revenue to an exhausted PIP pool nobody was watching and interest nobody invoiced. These are the four we eliminate:
No-fault carries $20,000 for medical expenses per person per accident, and unused wage-loss dollars cannot be moved into it. A course of therapy and imaging exhausts that pool quickly, and care delivered after exhaustion has no no-fault payer at all unless another source has been lined up first.
Interest on a clean claim not paid or denied in 30 days runs at 1.5% per month or any part of a month, and is payable to the provider at least quarterly. Practices almost never reconcile it, and a payer that never pays it faces no consequence unless someone counts.
Disputes over no-fault benefits of $10,000 or less go to mandatory arbitration under the Minnesota No-Fault Arbitration Rules, and the arbitrator keeps jurisdiction over amounts that accrue after filing. Practices that write off a reduced PIP balance are skipping the forum built for exactly that dispute.
Once a clean claim is paid, the payer contract must carry a 12-month deadline on adjustments and recoupments, with defined exceptions for coordination of benefits, subrogation, duplicates, retroactive terminations and fraud. Offsets outside that window should be dated and challenged rather than absorbed.
All health plan companies and third-party administrators must pay or deny a clean claim within 30 calendar days after receipt. Where they do not, interest runs from the day after the due date until payment or denial at 1.5% per month, payable at least quarterly, and the commissioner may penalise a health plan company that shows a pattern of abuse and systematic non-compliance.
Minnesota requires payer contracts to impose a 12-month deadline on all adjustments to and recoupments of a paid clean claim, other than coordination of benefits, subrogation, duplicate claims, retroactive terminations and cases of fraud and abuse. That gives providers a statutory answer to takebacks that arrive a year or two after payment.
Every policy provides at least $40,000 per person per accident in basic economic loss benefits, $20,000 for medical expenses and $20,000 for wage loss and replacement services, with no transfer between the two pools. No-fault pays first regardless of fault. Disputed benefits of $10,000 or less are resolved in mandatory arbitration, with the arbitrator retaining jurisdiction over amounts accruing after the petition is filed.
Medical Assistance and MinnesotaCare members are served by health plans including Blue Plus, HealthPartners, Hennepin Health, Medica and UCare, together with county-based purchasing organizations such as PrimeWest Health, South Country Health Alliance and Itasca Medical Care. Plan availability varies by county, so eligibility and plan assignment are verified before each visit.
MedStats Billing provides tailored billing solutions for a wide range of medical specialties, ensuring accurate coding, fewer denials, and faster reimbursementsto maximizes your revenue potential.
MedStats Billing handles MN–ITS enrollment, health plan and county-based purchasing credentialing, 30-day clock tracking, interest recovery, no-fault arbitration and workers’ compensation documentation across Minnesota, giving practices end-to-end RCM support in a no-fault state with a hard recoupment limit.
Claims are scrubbed against public programme and commercial payer edits before submission to drive clean first-pass reimbursement.
Every auto claim is screened for remaining medical benefits, priority of coverage and exhaustion before treatment continues, so care is never delivered against a pool that is already spent.
We track the 30-day clock on every clean claim and invoice the 1.5% monthly interest Minnesota attaches to late payment, rather than waiting for a payer to volunteer it.
Working knowledge of Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, UCare, Aetna, Cigna, UnitedHealthcare and the county-based purchasing organizations.
Whether you practise in Minneapolis, Saint Paul, Rochester, Duluth or Saint Cloud, our workflows adjust seamlessly as your group grows across the state.
HIPAA-compliant data handling and controlled access protect patient health information and billing records at every stage.
We integrate smoothly with widely used EHR platforms to ensure accurate data flow from documentation to claim submission. This reduces manual errors, speeds processing, and supports cleaner reimbursements.
We work alongside leading systems including:
Schedule a complimentary billing assessment with MedStats Billing to uncover hidden revenue loss, review the recoupments taken outside the 12-month limit, and quantify the interest your practice is owed on clean claims paid late.
Under Minn. Stat. § 62Q.75 all health plan companies and third-party administrators must pay or deny a clean claim within 30 calendar days after the date on which they received the claim. Where they do not, interest accrues from the day after that required payment date until the claim is paid or denied, at 1.5% per month or any part of a month, and interest must be paid to the provider at least quarterly.
Once a clean claim has been paid, the payer contract must provide a 12-month deadline on all adjustments to and recoupments of that payment. The exceptions are coordination of benefits, subrogation, duplicate claims, retroactive terminations and cases of fraud and abuse. Any other offset arriving after 12 months runs against the statutory requirement and should be challenged.
At least $40,000 per person per accident, consisting of $20,000 for medical expenses and $20,000 for non-medical losses such as wage loss and replacement services. The split is rigid — unused non-medical dollars cannot be applied to medical bills — so the practical ceiling on auto injury care is the $20,000 medical pool, and that pool is consumed quickly by imaging, therapy and specialist care.
Mandatory arbitration applies to claims for no-fault benefits where the total amount claimed at the commencement of arbitration is $10,000 or less, under the Minnesota No-Fault, Comprehensive or Collision Damage Automobile Insurance Arbitration Rules. Where the amount continues to accrue after the petition is filed, the arbitrator has jurisdiction over all amounts claimed, including those above $10,000. Above that limit, district court remains available.
Minnesota combines a medical fee schedule, updated annually, with treatment parameters that govern the type, frequency and duration of care for work injuries. That means a reduction or denial is frequently about whether care fell inside the parameters rather than what it cost, so documentation against the parameters, and a departure request where treatment needs to exceed them, is what preserves payment.
Medical Assistance and MinnesotaCare enrollees are served through health plans including Blue Plus, HealthPartners, Hennepin Health, Medica and UCare, plus county-based purchasing organizations such as PrimeWest Health, South Country Health Alliance and Itasca Medical Care. Availability varies by county, and county-based purchasing plans have their own contracting and submission requirements, so plan assignment is confirmed per visit.
We serve practices and healthcare facilities statewide, including Minneapolis, Saint Paul, Rochester, Duluth, Bloomington, Brooklyn Park, Plymouth, Woodbury, Maple Grove, Saint Cloud, Eagan, Eden Prairie, Mankato and Moorhead.
