Eligibility

PrimeWest Health strongly encourages providers to verify member eligibility prior to rendering services and submitting claims. PrimeWest Health also encourages providers to verify Minnesota Health Care Programs (MHCP) eligibility on all patients they see.

Eligibility Verification

Access member eligibility information through any of the following:

  1. PrimeWest Health’s web service (CORE certified) – Note: Your clearinghouse and system software program will need to support the eligibility transaction in the standard electronic data interchange (EDI) transaction ASC X12 270/271.
    1. Information provided in an EDI 271 transaction is not a guarantee of payment or coverage in any specific amount. Actual benefits depend on various factors, including compliance with applicable administrative protocol, date(s) of services rendered, and benefit plan terms and conditions.
  2. PrimeWest Health web portal. Prior registration is required using the Web Portal Registration Form.
  3. DHS Minnesota Information Transfer System (MN–ITS) web portal
  4. DHS Enrollment Verification System (EVS) Line: 1-651-431-2700 or 1-800-657-3613 (toll free)
  5. PrimeWest Health Provider Contact Center: 1-866-431-0802 (toll free)

PW_03-19_119
Updated_01/06/2020