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MN DHS Claims with Paying(Under Review) Status

With the Optum Review underway, certain claims have a Paying(Under Review) Status

Since the Governor's Announcement that MN will review submitted claims for certain Medicaid benefits and services, claims have begun to return with a "Paying(Under Review)" Status

The DHS is currently using Optum to review certain services. This pre-payment review process began late December 2025.

In Billiyo

To view and submit claims, head to: Billing>Claim Detail Report

After a claim's submission, any claim that is under review will have a "Paying(Under Review)" Status.

Once the green plus sign is selected on a claim, each individual line will have a "Internal review/audit." status.

Once this claim's review is completed, the claim's response will be updated in the agency's MN–ITS Electronic Remittance. 

Please be sure to complete an ERA Request Form, so claim information in Billiyo is updated with the agency's electronic remittance.

An ERA Request Form may be completed using the instructions in this article: 

MNDHS: How to Request Electronic Remittance Advice in Billiyo

Please Refer to this MN DHS Resource for further questions:  https://mn.gov/dhs/partners-and-providers/news-initiatives-reports-workgroups/minnesota-health-care-programs/provider-news/pre-payment-review-faq.jsp