Here are the detailed guidelines and laws of medical billing in Minnesota:Provider Allowed Amount

• The amount of the clinic or hospital's bill that the insurance company will allow to be charged. Under contracts between clinics and hospitals and insurance companies, the clinic or hospital must agree to certain discounts and cannot charge more than the discounted amount to a particular patient.

Timely Billing

• Providers must submit an itemized statement of charges on the prescribed billing form to the payer within 60 days of the service.
• MHCP (Minnesota Health Care Programs) is required to pay or deny clean claims within 30 days and complex claims within 90 days of receipt.

Coding Requirements

• Use applicable HIPAA-compliant codes and follow the most current guidelines.
• Use appropriate HCPCS 2-digit alpha, numeric and alphanumeric modifiers.
• Bill unlisted procedure codes only when a specific code is not available to define a service or procedure.

Billing Responsibilities

• Providers are responsible for all claims submitted to MHCP and for reconciling their claims.
• Providers must keep appropriate records according to state and federal retention requirements.
• Providers must accept MHCP reimbursement as payment in full for covered services provided to a member.

Billing Disputes

• If a clinic or hospital asks you to pay a bill that you believe should have been paid by your insurance company, call both the clinic/hospital and insurance company to see if there is still time for the claim to be processed.
• If a charge is denied, the insurer must send the provider a written notification outlining the basis of the denial by the 30-day deadline.

Financial Assistance

• Minnesota non-profit hospitals offer financial assistance programs to help people with limited income and assets pay their hospital bills.
• If a patient expresses an inability to pay an entire hospital bill at once, the hospital must work with the patient to see if a reasonable payment plan can be reached.

These guidelines and laws aim to ensure that healthcare providers and facilities follow specific procedures for billing and claims submission, protecting patients from surprise medical bills and ensuring timely and accurate payment for services.