====== How does MN-ITS work? ======


The instructions in the next few sections will help you familiarize yourself with how to upload files to the MN-ITS website and how to set some features that are essential for uploading batch files.

===== Minnesota Department of Human Services - Health Care Programs (MHCP) Helpful Links: =====
 
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&noSaveAs=1&Rendition=Primary&allowInterrupt=1&dDocName=dhs16_149203|MN-ITS Mailbox User Guide]] How to access and retrieve Remittance Advice (RA's)
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&Rendition=Primary&allowInterrupt=1&noSaveAs=1&dDocName=dhs_id_051490|Eligibility Inquiries and Responses (270/271)]]
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_142386|Claim Payment and Remittance Advice Transactions (X12 835)]]
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_009664#|MN-ITS Payment & Claim Cut-Off Calendars]]
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=MNITS_060101|Copy, Replace or Void Claims in MN-ITS Interactive]]
  * [[http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_FILE&RevisionSelectionMethod=LatestReleased&noSaveAs=1&Rendition=Primary&allowInterrupt=1&dDocName=dhs_id_051505|MN-ITS User Guide - Check the Status of a Submitted Claim]]
===== Uploading your first file to the MN-ITS website: =====

Before you can submit batch files through MN-ITS, the batch option will have to be selected in the "User Administration" section. Search for the user, click on their user ID, and make sure the "Batch Functions" is checked under "MN-ITS Functions" of the "Modify User" screen. Only a MN-ITS Administrator can make this change.

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Before you proceed with the upload described below, select some records to be sent and select "Test Mode".
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DHS must approve your batch file before they will accept "production" files. You will only be able to submit "Test" files until you are approved. Each district will have to send their own test file (for each district/MN-ITS account).

===== Upload a "Test File" to MN-ITS: =====
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NOTE: Follow the instructions for logging into the Test Region in the lower center of the page. If you have never uploaded batch files to MN-ITS you may need to create a test account.
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  - Log in to MN-ITS with the district's username and password.
  - Click on the "MN-ITS: Home" link at the top center of the page.
  - Click the link to the "Test Region" under "Related Pages" located on the right side of the page.
  - Once in the Test Region, click on the "MN-ITS" link then "Submit Transactions".
  - Click on the "Choose file" button and select the (.txt) file that you saved.
  - In the drop down menu under "Transaction Type" select "X12 or Pharmacy 1.2".
  - You may also enter a "Description" for the file you are uploading.
  - Click the "Upload & Submit" button.
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Once you click the "UPLOAD & SUBMIT" button, your test file will be uploaded to DHS and the text shown on the bottom of the page will tell you if your file uploaded successfully. It does not take long to hear back about the "Test" file (usually just a day or two). Check the "999" folder in your MN-ITS Test Region Mailbox under "Transaction Responses". If your "Test" file did not pass, you will be given a report with the reasons why. If your "Test" file passed, it will be revealed in the "999" file name.
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====== Uploading X12 compliant batch files to the MN-ITS website: ======



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Your "Test" file must be approved before you can submit production files.
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===== Upload an "MA Forms" file to MN-ITS: =====


  - Log in with the district's username and password.
  - Click the "MN-ITS" link.
  - Click the "Submit Transactions" link.
  - Click on "Browse" and find the SpEd Forms (.txt) file that you saved through MA Forms. The file name will then appear in the window next to the "Browse" button.
  - In the drop down menu under "Transaction Type" select "X12 or Pharmacy 1.2".
  - You may also enter a "Description" for the file you are uploading.
  - Click the "UPLOAD & SUBMIT" button.
  - Check the "<html><a href="#999">999</a></html>" response in your MN-ITS mailbox.
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Once you click the "UPLOAD & SUBMIT" button, your file will be uploaded to DHS and the text shown on the bottom of the page will tell you if your file uploaded successfully.

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===== Retrieving your Remittance Advice and/or X12 Response files: =====


Every other Tuesday you can review the "Remittance Advice (.PDF)" files or retrieve your "X12 Responses" (835 or 271) to import into MA Forms.

Check the DHS web site for: MHCP Payment & Claim Cut-off Calendars

===== Review the "Remittance Advice": =====


  - Log in with the district's username and password.
  - Click the "Mailbox" link.
  - Click the "Transaction Responses" link.
  - Select a date range.
  - Click the radio button for "835_PDF".
  - Click "Search".
  - Click the "...RA01.pdf" to view/save your Remittance Advice.
===== Retrieve your "X12 Response" files: =====

  - Log in with the district's username and password.
  - Click the "Mailbox" link.
  - Click the "Transaction Responses" link.
  - Select a date range.
  - Click the radio button for "835_X12".
  - Click the file name and "Save" it to your designated folder.

==== How can I find the meaning of the codes that appear next to unpaid claims on my RA? ====

When a claim is unpaid, DHS will provide a reason for this denial with the "Claim Adjustment Reason Code" (ADJ RSN) and/or the "Remittance Advice Remark Code" (REMARK). The Claim Adjustment Reason Code usually has a generalized description. The Remittance Advice Remark Code has a more specific description. You can use these descriptions to help determine why the claim was denied.

===== Identifying remark codes on the RA: =====
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You can look up any of the [[http://www.wpc-edi.com/reference/codelists/healthcare/claim-adjustment-reason-codes/|Claim Adjustment Reason Codes]] and [[http://www.wpc-edi.com/reference/codelists/healthcare/remittance-advice-remark-codes/|Remittance Advice Remark Codes]].
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  - Log in with the district's username and password
  - Click on "Mailbox".
  - Click on "Remittance Advice (.PDF)"
  - Open the desired PDF file.
  - Note any Remark codes in the "REMARK" column.
  - This particular example shows the
  - "Group Code" = CO
  - "Adjustment Reason" = 97
  - "Remark Code" = M86
  - The claim was denied because a duplicate claim had already been made for this service.

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 {{ :mnits_remark_codes_new2015.png?nolink&500|}}
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===== I submitted claims but they've never shown up on my Remittance Advice. =====


For every batch file you submit to MN-ITS, a response is returned in the form of a 999 Functional Acknowledgement. These can be viewed minutes after uploading a batch file. If there is an error in your batch file an "R" (Rejected) will be shown in the AK5 and AK9 segments. If a batch is rejected, it will not be processed, but you can fix the errors, create another batch and immediately upload it again.
<html><a id="999"></a></html>
===== Viewing the 999 Transaction Response: =====

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The number to the right will be the number of files in the folder.
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  - Log in with the district's username and password.
  - Click on "Mailbox".
  - Click on "Transaction Responses".
  - Click the "999" folder.
  - Click on a document name and choose "Open". A new window will display the 999 response.
==== Batch that had been accepted: ====

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%%ISA*00* *00*133441911 *30*41-1674742*ZZ*123456789*130701*0828*^*00501*0000001*0*P*:~

GS*FA*41-1674742*123456789*20130701*0828*1*X*005010X231A1~

ST*999*0001*005010X231A~

AK1*HC*5943*005010X222A1~ <--- AK1* ["Health Care"] * [Batch Number or MA Forms Transaction ID] 

AK2*837*0001*005010X222A1~

%%<html><span style="background-color: yellow;">IK5*A~ <--- AK5* [Accepted]

AK9*A*1*1*1~ <--- AK9* [Accepted]</span></html>%% * [total sets] * [received sets] * [accepted sets] 

SE*6*0001~

GE*1*1~

IEA*1*000000001~%%
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==== Batch that had been rejected: ====
 
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%%ISA*00* *00*133441911*30*41-1674742*ZZ*123456789*060209*0828*U*00401*0001*0*P*:~

GS*FA*41-1674742*123456789*20060209*0828*1*X*004010X098A1~

ST*999*0001~

AK1*HC*2~ <--- AK1* ["Health Care"] * [Batch Number or MA Forms Transaction ID] 

AK2*837*0001~

AK3*N4*16**8~ <--- AK3* [error in segment N4] * [segment position 16] ** [AK3 error code 8 (below)] 

AK4*2**5*MN.~ <--- AK4* [error in element #2] ** [AK4 error code 5 (see below)] * [data that caused the error] %%

<html><span style="background-color: yellow;">IK5*R*5~ <--- AK5* [Rejected] 

AK9*R*1*1*0~ <--- AK9* [Rejected]</span></html> %%* [total sets] * [received sets] * [accepted sets] 

SE*8*0001~

GE*1*1~

IEA*1*000000001~%%

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===== AK3 ERROR CODES =====
  * 1 Unrecognized segment ID
  * 2 Unexpected segment
  * 3 Mandatory segment missing
  * 4 Loop Occurs Over Maximum Times
  * 5 Segment Exceeds Maximum Use
  * 6 Segment Not in Defined Transaction Set
  * 7 Segment Not in Proper Sequence
  * 8 Segment Has Data Element Errors
===== AK4 ERROR CODES =====

  * 1 Mandatory data element missing
  * 2 Conditional required data element missing
  * 3 Too many data elements
  * 4 Data element too short
  * 5 Data element too long
  * 6 Invalid character in data element
  * 7 Invalid code value
  * 8 Invalid Date
  * 9 Invalid Time
  * 10 Exclusion Condition Violated

Finding and correcting errors using the 999 Transaction Response: We can use the information on the (rejected) 999 to determine why the batch file was rejected.

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Open the file with Microsoft Word or a common word processor. With Microsoft Word you can use the "Replace" feature to break the code up into segments so that it looks more like the example below. In the "Edit" menu click on "Replace", type ~ into the Find field and ~^p into the Replace field and click on "Replace All". You might also want to use the "Edit" menu, choose "Select All" and change the font to "Courier New" size 10.
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Open the original batch file (on your computer) that corresponds with the name of the 999. In our example, the name of the rejected batch file is: ma2 777 060209 0826.txt. "ma2" denotes Transaction ID #2, "777" is the district number, the date (two digit year, month, day) and time (military hour, minute) the batch was created is also included in the name.

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Each line in the example below is a "segment". Each segment ends with a tilde (~). Each segment has "elements" separated by an asterisk (*). The transaction set always begins with the ST segment. AK4 reveals that the error is in "element" #2, the AK4 error code #5 says that the "Data element is too long" and that "**__MN__**." is the actual error that caused this batch file to be rejected.
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In the 999, AK3 shows that there is an error in segment N4, the error occurs 16 segments into the transaction set and AK3 error code #8 tells us that the "Segment Has Data Element Errors".

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This particular element cannot be over 2 digits long and must have the standard two digit postal abbreviation.
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===== Example: Code of the original Batch file =====
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%%''
ISA*00* *00* *ZZ*123456789*30*41-1674742*060209*0826*U*00401*0000002*0*P*:~

GS*HC*123456789*41-1674742*20060209*0826*2*X*004010X098A1~

1 - ST*837*0001~

2 - BHT*0019*00*180*20060209*0826*CH~

3 - REF*87*004010X098A1~

4 - NM1*41*2*Brisbane Schools*****46*567891234~

5 - PER*IC*Some Contact*TE*5551231234~

6 - NM1*40*2*%%<html><span style="background-color: yellow;">MN</span></html>%% Department of Human Services*****46*41-1674742~

7 - HL*1**20*1~

8 - NM1*85*2*Brisbane Schools*****24*12-3456789~

9 - N3*101 Brisbane Lane~

10 - N4*Brisbane*%%<html><span style="background-color: yellow;">MN</span></html>%%.*561641234~

11 - REF*1D*123456789~

12 - HL*2*1*22*0~

13 - SBR*S*18*******MC~

14 - NM1*IL*1*Student*Some****MI*12345678~

15 - N3*109 Plum Street~

16 - N4*Somewherein*%%<html><span style="background-color: yellow;">MN</span></html>%%.*56123~

DMG*D8*19950505*M~

NM1*PR*2*%%<html><span style="background-color: yellow;">MN</span></html>%% Department of Human Services*****PI*41-1674742~

CLM*0777-0777-12345678*32.73***03::1*Y*A*Y*Y*C~

LX*1~

SV1*HC:T1018:U1*10.63*UN*1~

DTP*472*D8*20060102~

LX*2~

SV1*HC:T1018:U8*22.1*UN*10~

DTP*472*D8*20060102~

SE*26*0001~

GE*1*2~

IEA*1*000000002~

''%%
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