Billing For Private Insurance


Mains’l Services maintains a system to regularly, consistently and accurately bill through Therapy Notes program and Minnesota’s automated Medicaid Management Information System, MNITS on behalf of clients enrolled in medical assistance programs. 
Mains'l Services receives updates from contracted private insurance agency’s regarding current contracts, contract renewal, claim submission or service provision. 
Mains'l Services monitors the Minnesota Department of Human Services web site ( for any updates and changes to the procedures, tasks or responsibilities of the Agent in billing through MNITS. 
Mains'l Services subscribes to any and all automated updates from the Minnesota Department of Human Services regarding billing through MNTS.


NEW CLIENT Clinicians add new client’s information into Therapy Notes and will send an email to Accounts Receivable (AR) department to check eligibility. The AR department emails clinician back with eligibility information. Once it is determined that the client is eligible to be seen; the clinician schedules an appointment with the client. The clinician will enter session information into Therapy Notes to be sent in for payment. 


Clinician verifies in the client profile for co-pay in Therapy Notes. If applicable the Clinician asks the client to pay the co-pay at the beginning of the session.  Clinician collects the co-pay and provides a written receipt to the client.  If client is unable to pay at the time of service a statement will be generated within 30 days and sent to their address on file. Mains’l only accepts checks or money order.

Clinician enters in all private insurance information required for billing by Therapy Notes. Therapy Notes notifies AR on the billing screen that there are entries for payment submission. AR electronically sends claims through Therapy Notes.

Once the 835 form is electronically submitted into Therapy Notes from the clearinghouse AR applies all payments to the client’s claims.  As payments are received and posted in Therapy Notes the AR department will add the date of payment, the amount of payment and payer into the spreadsheet located on the T drive/month end/Mental Health Payments for the general ledger account. A report is printed out for exceptions that the system is unsure of how to handle the reconciliation. The AR manager will research and resolve those exceptions.     
For clients using Medical Assistance (MA) once the state receives the files and processes the claims that were submitted for payment the State of MN DHS will create an 835 file to be downloaded and the remittance advice to coincide with the information in the 835 file.  AR will download the 835 file and print off the remittance advice to reconcile the payments.
If claim is denied for any reason AR corrects and/or investigates the denial reason and follows up, as necessary, with clinician. AR resubmits 835 form with correction to third party payer.   

At month end, the Finance Coordinator reviews the general ledger to ensure accuracy of proper revenue and expense recognition.
AR and Chief Financial Officer will review the aging monthly to review and research any and all outstanding billings that may have been denied.

System updates are performed regularly to be in compliance with any changes to the procedures, tasks, or responsibilities of Mains’l Services in billing.


835 Form