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AUC eHandbookThis handbook provides anhistorical overview of the MinnesotaAdministrative UniformityCommittee and an illustrativeoverview of its currentorganizational structure,membership, policies, and operatingprocedures. It is intended for use bypotential and new AUC members.AUCeHandbookOctober 2014
AUC eHandbookBackground and PurposeEstablished as a sub-workgroup in 1992, the Administrative UniformityCommittee (AUC) is now an independent voluntary, broad-based entityrepresenting Minnesota health care public and private payers, hospitals, healthcare providers and State agencies, working together to standardize, streamline,and simplify health care administrative processes.The mission of the AUC is to develop agreement and consensus among itsmembers in implementing consistent, uniform standards for health carebusiness transactions, which will reduce administrative costs and increaseefficiency of health care delivery for both providers and payers.AUC Past sentMinnesotaCarehealthcarereform mandatesStandard papermanualsElectronictransactionsBest PracticesStandard paperformsUniformstandardcompanionguides (rule oflaw)1994AdministrationSimplification Actof 1994Standardpatient ID cardsUniform EDIstandardsCompanionGuidesmaintenanceFebruary 21, 2012Recipient ommittee Day"Rx ePACompanion GuideCodingCoding gridmaintenanceContributionson nationallevelContributions onnational levelAs shown above, the AUC began its work to comply with MinnesotaCarehealthcare reform mandates in the early 1990’s. During 2000-2006, the AUCdeveloped standardized paper manuals, forms, patient ID cards, and uniformelectronic data interchange (EDI) standards. Following the enactment ofMinnesota Statutes, section 62J.536, the AUC leveraged the work andexpertise of several groups and through collaboration developed rules of law(Minnesota Uniform Companion Guides) for standard X12 5010 electronictransactions for eligibility, claims, payment/advice, and acknowledgments.Minnesota Uniform Companion Guides can be accessed at: Companion Guides.The AUC also developed Best Practices to be used in conjunction with theapplicable 5010 transactions.
AUC eHandbookAUC Current StructureWorking in consultation with the Minnesota Department of Health (MDH), theAUC is led by an Executive Committee and accomplishes its work throughtechnical advisory groups each assigned for developing and maintainingMinnesota rules and best practices for specific administrative transactions.ExecutiveCommitteeMinnesotaDepartment ofHealthOperationsCommitteeClaims DDTAGEligibilityTAGEOB/RemitTAGACK TAGLegislativeTAGHPID/OEIDTAG*MedicalCode TAGRx EPATAG**The HPID/OEID and RxEPA TAGs were created in 2013.Visit the AUC website at: AUC Mission to learn more about the AUC and its work.Each of the AUC TAGs is led by subject matter experts and the primary focus oftheir work is to address administrative simplification issues and recommendstandardized administrative processes to ensure compliance with M.S. 62J.536,HIPAA regulations, and CORE operating rules.1. AUC COMMITTEESExecutive Committeedevelops meetingagendas for andpresides at OperationsCommittee meetings,and serves as liaisonto MDH and otherorganizationsOperations Committeeserves as AUCcommittee of thewhole for oversight,strategy and prioritiesconsistent with theAUC missionPage 2
AUC eHandbook2. AUC TAGSEach of the TAGs, except the AUC Legislative TAG, is responsible fordeveloping and maintaining Minnesota Uniform Companion Guides and bestpractices for the X12 5010 electronic transactions noted below.MCTRx ePA Rx ePAcompanionguideAcknowledgment TA1, 999, 277CACompanionGuides and bestpractices*Appendix A of837P and 837ICompanion Guidesand medical codingbest practicesLegislative AdministrativeSimplificationAct (M.S.62J.50-61) 837 Institutional 837 Professional 837 DentalClaims DD 837 ClaimsCompanionGuides and bestpractices NCPDP D.0 (2)EOB/Remit 835 CompanionGuide and bestpracticesEligibilityHPID 270/271CompanionGuide and bestpractices HPID bestpracticesRoles and Responsibilities of AUC Chairs/co-chairsSome of the responsibilities for which the AUC Chairs/Co-chairs areaccountable for are approving the TAGs annual meeting calendar; managingthe work of the group to accomplish its charge; managing the distribution listsof its members; leading TAG meetings; scheduling meetings through MDH;distributing draft minutes to TAG members; reporting on TAG activities at AUCOperations meetings; and updating TAG’s webpage. Other tasks may beassociated with the chair/co-chair’s responsibilities. To see the complete list of“Responsibilities of TAG Chair/Co-chair”, please review AUC Policy #3. For acomplete list of AUC policies regarding TAG please visit the AUC website at:AUC Policies.Page 3
AUC eHandbookAUC Member OrganizationsAUC Membership is free and open to any health care provider and payer doingbusiness in Minnesota. To learn more about the AUC member organizations(listed below), visit the AUC website at: AUC Membership Information and clickthe name of any member organization to access their website. Note: List belowis subject to change, please visit website for current members.AUC meetings are open, public meetings guided by the AUC AntitrustStatement and may be attended by any interested individual(s). The AUCannual meeting calendar for all AUC committees and technical advisory groups(TAGs) can be viewed at: AUC Annual Calendar. More specific and detailedmeeting information for individual committees and TAGs can be found on theirmeeting information page and accessed from each group’s link at: AUC TAGpage.PROVIDERS Aging Services ofMinnesota Allina Hospitals & Clinics American Association ofHealthcare AdministrativeManagement Care Providers ofMinnesota CentraCare HealthSystem Children’s Hospitals andClinics of Minnesota CVS Pharmacy Essentia Health Fairview Health Services HealthEast HealthPartners MedicalGroup & Regions Hospital Hennepin County MedicalCenter Mayo Minnesota ChiropracticAssociation Minnesota Dental Association Minnesota MedicalGroup ManagementAssociation Minnesota PharmacistsAssociation Olmsted Medical Center Park Nicollet HealthServices PrairieCare Ridgeview Medical Center Minnesota HospitalAssociation Sanford Health St. Luke’s Minnesota MedicalAssociation University of MinnesotaPhysicians Metropolitan Health Plan Minnesota Council of HealthPlans Minnesota Department ofHuman Services Minnesota Department ofLabor and Industry PreferredOne PAYERS Aetna Blue Cross Blue Shield ofMinnesota Delta Dental of Minnesota HealthEZ HealthPartners HealthPlan MedicaPage 4PrimeWest HealthSanford health PlanSilverscriptUCare MinnesotaUnitedHealth GroupWisconsin PhysicianServices
AUC eHandbookAUC and the Minnesota Department of Health (MDH)The AUC serves as an advisory body to the Minnesota Department of Health indeveloping and implementing the provision of the Administrative SimplificationAct of 1994 (ASA), Minnesota Statues Section 62J.50-62J.61. In 2007, the MNlegislature amended the ASA and required the development, adoption and useof state uniform companion guides, i.e., Minnesota Uniform Companion Guides(MUCGs), which are rules of law. Minnesota Statutes Section 62J.536 chargesMDH to consult with the AUC in developing these guides. All health careproviders and group purchasers doing business in Minnesota must complywith MUCGs (laws).Links to AUC Information and Resources for Administration SimplificationLinkAUC HomeAUC AboutAUC CalendarAUC TAGs Home PageMinnesota UniformCompanion GuidesAUC Best PracticesAUC CodingHIX Grace Period BestPracticesDescriptionMain AUC websiteProvides information about AUC, its mission, history,membership criteria, member organizations, policies,leadership and antitrust statementProvides calendar information for all AUC Ops and TAGmeetings, including time, date, location, meeting info andmeeting minutesInformation about AUC’s Technical Advisory Committeesand the focus of each committeeRules of law developed by the AUC as required by MNStatutes section 62J.536 and related rules.Information on AUC’s best practice documents which areconsensus recommendations of the AUC to furtherstandardize and harmonize health care administrativetransactions for providers and group purchasers. The bestpractices are for use with the applicable version 5010transactions.Provides clarification and answers to frequently askedquestions about recommended ways to code for healthand medical services and also addresses new codestandards pertaining to administrative simplificationuniformity in Minnesota. Note: Codingrecommendations are for medical treatment andservices applicable to the 837 Professional and 837Institutional companion guidesProvides three best practices for Health InsuranceExchange (HIX) 90-day grace period notifications for usewith the applicable version 5010 transactions:Acknowledgment (277CA), Eligibility Response (270) andPayment/Advice (835)Page 5
AUC eHandbookLinkICD-10AUC FormsMinnesota's HealthCare nformation regarding ICD-10 implementation, including alink to the Minnesota ICD-10 Collaborative webpage.Required forms for submitting appeals; claimsattachments; prior authorization requests for aprescription drug(s); and requests seeking clarification ofmedical coding issues, coding for newservices/treatments, or other uniform administrativesimplification issuesFact sheet developed by Minnesota Department of HealthCenter for Health Care Purchasing Improvement providingbackground information regarding HIPAA of 1996regulations, routine administrative health caretransactions, and Minnesota’s three-pronged approach tohealth care administrative simplificationPage 6
AUC eHandbookAPPENDIXURL ADDRESSES FOR DOCUMENT LINKSLINKURL ADDRESSCompanion AUC dfAUC Policy y003.pdfAUC .htmAUC n.pdf(See Section 5 for membership criteria)AUC /auc/memborg.htmAUC Antitrust st.pdfAUC Annual .htmAUC TAGs Minnesota StatutesSection id 62J.50Minnesota StatutesSection 62J.536https://www.revisor.mn.gov/statutes/?id 62J.536AUC C C Best UC HIX Grace Period icd10/icd10index.htmlAUC nnesota’s Health CareAdministrativeSimplification eetadminsimp.pdf(Access to M.S. 62J.50 only)(Can also be accessed from AUC Best Practices page above)Page 7
(Minnesota Uniform Companion Guides) for standard X12 5010 electronic transactions for eligibility, claims, payment/advice, and acknowledgments. Minnesota Uniform Companion Guides can be accessed at: Companion Guides. The AUC also developed Best Practices to be used in conjunction with the applicable 5010 transactions. Recipient of Governor's
