Date:
4/2/2026
MNeConnect Client Onboarding Sheet
Account Details
Client Details
Account Name (Business Name)
*
Account Name Required
UMPI (ID's registered with the Payer)
*
UMPI Required
If eligible for NPI ( NPI registered with the Payer)
Primary Taxonomy Code (Mandatory for UCare / SCHA Payer Only )
*
Tax ID (Facility Tax ID)
*
Valid Tax ID Required
TaxID is always a 9 digit Number
Legacy ID / Payer Provider ID / GPN ID (If you have any)
*
Legacy ID Required
Preferred User Name 17-8 characters (no special characters allowed)
*
User Name Required.
17-8 characters (no special characters allowed)
Is your Billing Provider (Facility) the same as your Rendering provider (Physician) (Yes/No)
*
Yes
No
Account Type (Sole Practitioner, Organization)
*
Sole Practitioner
Organization
Enter Account Type
Claims Volume (No of Claims)
*
Enter Claims Volume
Only Numbers
Frequency of Claims Submission ( Daily / Weekly / Monthly )
*
Daily
Weekly
Monthly
Frequency Of Claims Submission Required
Payer Name (Insurance company name)
*
Payer Name Required
EDI Payer ID
*
Enter Payer ID
Type of Claims (CMS-1500 / UB-04 / ADA)
*
Enter Type Of Claims
Note: If you have mutiple 'Rendering Providers' make sure you add the rendering providers in your respective accounts in the Provider tab.
Account Details
Client Details
Last Name
*
Last Name Required.
Last Name should be a-z A-Z 0-9 hypen comma space apostrophe are allowed with minimum 2 chars length.
First Name
*
First Name Required.
First Name should be a-z A-Z 0-9 hypen comma space apostrophe are allowed with minimum 2 chars length.
Email
*
Invalid Email ID
Invalid Email ID
Address
*
Enter Correct Address
City
*
, State
*
, Zip Code
*
City Required
Phone
*
Phone should be in xxxxxxxxxx or xxx-xxx-xxxx format.
Enter valid Phone
Additional Yearly Paid Services
Client Details
Eligibility Service - Request / Response,
$ 600
- (Yes / No)
*
Yes
No
837 Batch Claims Submission Implementation (Includes One-time set up fee & Yearly $1200 Batch parser fee)
*
Yes
No
ERA (Electronic Remittance Advice)
$ 1200
(Yes / No)
*
Yes
No
Claim Attachments Required - (Yes / No)
*
Yes
No
How did you hear about MN E-Connect? - Payer / Email / Google / Social Media / Friends
Word of Mouth (Please do mention the specific source)
*
Enter about How did you hear about MN E-Connect
Minimum 5 characters (no special characters or no numbers allowed)
LOB (Line of Business)
For reference, example entries could include: (e.g., Individual & Family Plans; The Minnesota Housing Stabilization Services (HSS))
Enter about the Line of Business