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NEW Provider Response Timeframe

Providers will have 15 calendar days to respond to pended authorization requests beginning December 1, 2019.We will deny the request if you do not respond within 15 days and you will need to submit a new request. View DHS official notification at https//mn.gov/dhs/ under the News and Updates section.
Posted: 11/21/2019

MN Retrospective Post Payment Claim Reviews

Minnesota Health Care Programs Retrospective Post-Payment Reviews are conducted by KEPRO. Each quarter the STATE will focus on select outpatient and inpatient review objectives. If your claim is selected, you will receive a Request for Medical Records via fax notification. The Minnesota Department of Human Services (DHS) will review the results of the reviews. No additional action is required by the provider after submittal of the requested medical records. DHS will contact the provider ONLY if follow up is indicated.
Posted: 2/5/2019

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KEPRO is URAC accredited in Health Utilization Management and Case Management. We are also licensed to perform medical reviews in 29 states.

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