|Claim Reconsideration Form/|
Provider Appeal Form
|Provider Adjustment Request Form||4357w (pdf)|
|Attachment Cover Sheet||4349 (doc)|
Use the chart below to quickly find phone numbers and addresses for easy claims submission. For pharmacy claims, see Pharmacy.
|Medical/Behavioral Health Services|
|SCHA Provider Portal (website)
Payer Identification Number - 81600
|Dental Services||Delta Dental
P.O. Box 1328
Minneapolis, MN 55440
Payer Identification Number - 07000
Minnesota Uniform Companion Guides
Minnesota Uniform Companion Guides (web)The Administrative Uniformity Committee (AUC) provides common billing practices for Minnesota payers and providers. The companion guides help determine the most appropriate practices for your agency/facility.