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In January 2021, the Department of Labor and Industry (DLI) released studies about the ambulatory surgical center payment system (ASCPS) and hospital outpatient fee schedule (HOFS) statutes. As required under Minnesota Statutes §§ 176.1363 and 176.1364, the studies reviewed payment accuracy and timeliness under the respective statutory provisions.

As part of these studies, DLI analyzed the reasons for payment errors in submitted cases. A wide variety of error reasons were found in these samples. The tables below describe the proper payment practices for the types of errors, including errors in payment of HOFS bills with J1 services, HOFS bills with no J1 services and ASCPS bills. 

Insurers are encouraged to review the tables for information about how to correct and prevent payment errors for future cases.

If you have further questions about ASCPS or HOFS, contact DLI’s medical policy staff at 651-284-5052 or medical.policy.dli@state.mn.us.

Tables