Minnesota Stat §62Q.75 requires health plan companies to pay or deny clean claims within 30 calendar days of receipt. Late claims accrue 1.5% monthly interest, calculated from day 31 and paid separately and itemized quarterly.
Minnesota's 30-Day Payment Requirement
Health plan companies in Minnesota must process clean claims within 30 calendar days of receipt. A clean claim contains all necessary billing and clinical information. The 30-day clock starts immediately upon receipt, regardless of claim submission method (electronic or paper).
Interest Accrual and Payment
Interest accrues at 1.5% per month on any unpaid clean claim, beginning on day 31. Unlike some states that compound interest, Minnesota's interest is simple monthly interest. Importantly, the interest must be paid separately from the claim payment and itemized on the remittance. The health plan cannot bundle interest into the claim payment amount.
Incomplete Claims and Clock Restart
Health plans must request missing information within 10 business days of receiving an incomplete claim. Once the health plan identifies the deficiency, the provider has an opportunity to resubmit the complete claim. A new 30-day period begins upon receipt of the complete claim, not from the original submission date.
Exceptions to Interest Obligation
The health plan does not owe interest if the payment delay results from an investigation into potentially fraudulent or abusive billing. However, the health plan must have documented evidence that a fraud investigation was actually underway. This exception does not apply to routine claim processing delays.
Enforcement and Compliance
The Minnesota Department of Commerce enforces prompt pay requirements under MN Stat §62Q.75. Health plans that consistently miss payment deadlines are subject to regulatory examinations and can face enforcement actions.
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Frequently Asked Questions
What is Minnesota's monthly interest rate on unpaid claims?
Minnesota requires 1.5% per month interest on unpaid clean claims beginning day 31. Interest must be paid separately and itemized quarterly on the claim payment or denial notice.
Can a Minnesota health plan avoid paying interest by claiming fraud review?
No interest is owed if the payment delay is to investigate potentially fraudulent or abusive billing. However, the health plan must have documented evidence of fraud investigation before denying the interest claim.
Related Resources
- Minnesota Balance Billing Protection
- Minnesota Surprise Billing Law
- All State Billing Laws
- Clean Claim Standards Overview