Sage Billing

Reimbursement rates are based on Medicare reimbursement and are subject to adjustment as Medicare adjusts rates. Sage is the payer of last resort except for patients who have coverage with IHS. Providers must submit the denial explanation of benefits with the claims and report any amount paid by insurance. Providers must not charge enrolled patients for Sage-covered services.

Sage has a timely filing limit of 120 days. Claims, patient forms, and results must be received by Sage within 120 days from the date of service. Sage only accepts electronic claims (see clearinghouse information below). 

Providers needing to submit paper claims should contact Sage at 651-201-5630 or email at health.sagebilling@state.mn.us to set up a plan.

Claims process based on Sage receipt of the required patient enrollment, consent, health forms and results from providers. Without this information, claims will remain in Wait status and will eventually be denied for exceeding the 120-day timely filing limit. The Sage paper remittance advice that is mailed to provider billing contacts after each payment contains error messages for the claims remaining in Wait status. Sage does not accept or send the 276 & 277 claim status & response EDI files.

Reimbursement rates

Sage only accepts CPT codes listed on Sage Program Reimbursement Rates (PDF).

Providers must not charge enrolled patients for Sage-covered services. Also, providers must not charge enrolled patients for non-Sage covered services unless the patient has been fully informed about their responsibility to pay for these services prior to receiving them.

Critical claim information

The following are requirements for claims to Sage to accept or process them effectively:

• Provider billing NPI, tax ID, name, and address of billing entity.
• Patient’s name, date of service, and correct Sage encounter number. Sage encounter number is assigned by the clinic where services were initially rendered or ordered. Sage patients must not be charged for services denied by Sage due to providers not using the correct encounter number on claims.
• CPT codes being billed.
• Charge for services provided.

Clearinghouse information

The Sage Program works with the Utah Health Information Network (UHIN) clearinghouse for receiving Claims (837’s) and sending Electronic Remittance Advices (835’s).

If you do not currently use a clearinghouse, you may enroll with UHIN by contacting enrollment@uhin.org for more information.

If you have a clearinghouse, please have them contact UHIN Customer Service at phone 1-877-693-3071 or email customerservice@uhin.org to connect with Sage.  They need to reference the following UHIN Payer ID and TPN:

• UHIN Payer ID: MNDH1
• UHIN TPN: HT007999-001

Sage remittance advice

The Sage paper remittance advice contains information on claim status for claims submitted to Sage. Wait status indicates a claim is pending for further information to adjudicate claim. The reason why the claim is pending is listed. Claims that have been adjudicated will be listed under Paid or Denied. When a claim is denied, there will be a denial reason listed at the end of the claim line.

For questions or more information, please contact Sage Billing at 651-201-5630 or at health.sagebilling@state.mn.us.