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How to file a claim with us
A claim is a request for us to pay for covered benefits under your plan. You or your provider must file a claim before we can reimburse costs according to your plan’s coverage.
There are different types of HealthPartners claims, depending on the plans or products you have, including:
- Medical and dental claims
- Pharmacy claims
- Consumer-directed health plan (CDHP) claims, like Flexible Spending Accounts (FSAs) and Health Reimbursement Accounts (HRAs)
- If your primary insurance isn’t with HealthPartners, you’ll need to provide an Explanation of Benefits (EOB) from your primary insurance company when submitting a claim to us as a secondary payer.
- If you have a Medical Assistance (Medicaid) plan with us, we’re unable to process claims you submit yourself.
If you have a question about how to file a claim with us, we’re here to help. Call Member Services at the number on the back of your member ID card or
These are claims related to medical care, services or products covered under your HealthPartners medical insurance plan.
In-network providers are required to submit claims on your behalf. If your provider is in network, check to make sure they have your current insurance information on file. If you need further assistance, call Member Services at the number on the back of your member ID card or
If you used an out-of-network provider for covered care, services or products, ask if they’ll submit a claim to us on your behalf. If they won’t, you can send us an itemized statement or detailed receipt (and supporting documentation) to get reimbursed for amounts you owe out of pocket that are covered by your plan. You may need to work with your provider to get the necessary information to file your claim.
These are claims related to dental care, services or products covered under your HealthPartners dental insurance or Medicare plan.
In-network providers are required to submit claims on your behalf. If your provider is in network, check to make sure they have your current insurance information on file. If you need further assistance, call Member Services at the number on the back of your member ID card or
If you used an out-of-network provider for covered care, services or products, ask if they’ll submit a claim to us on your behalf. If they won’t, the out-of-network claim process depends on whether you have:
- A dental insurance plan with us; OR
- A Medicare plan with us that covers dental services
Out-of-network dental claims if you have a dental insurance plan
Send us an itemized statement or detailed receipt (and supporting documentation) to get reimbursed for amounts you owe out of pocket that are covered by your plan. You may need to work with your provider to get the necessary information to file your claim.
We don’t have a standard out-of-network dental claim form, but your submission must include:
- Member name and ID number (written on each page)
- Date(s) of service
- Care provider name
- Care provider address
- Care provider tax ID number
- Care provider phone number
- ADA codes and descriptions, including tooth numbers or quadrants where applicable
- Amount billed
- Proof of payment (if you already paid your provider)
Please note that some services may require additional documentation. We’ll follow up with you if we need more details.
Please mail the above information to:
HealthPartners Dental Claims – 25510F
P.O. Box 1172
Minneapolis, MN 55440-1172
If you’ve already paid your provider, we’ll reimburse you for covered amounts. If you haven’t yet paid your provider, we’ll reimburse your provider for covered amounts.
Out-of-network dental claims for covered services under a Medicare plan
Fill out and send us the
Be sure to include all information and documentation that’s asked for, including dated receipts, itemized bills, and dental codes and service descriptions for each service you’re requesting reimbursement for. You may need to work with your provider to get the necessary information to file your claim.
If you’ve already paid your provider, we’ll reimburse you for covered amounts. If you haven’t yet paid your provider, we’ll reimburse your provider for covered amounts.
These are claims related to prescription medicines covered under your HealthPartners medical insurance or HealthPartners prescription drug plan. (Please note that some employers use insurers besides HealthPartners to cover prescription medicines. If this applies to you, you’ll have a separate ID card from a separate company for your pharmacy benefits, and you’ll need to contact that company regarding how to submit a claim.)
Generally, your HealthPartners insurance will be checked when you fill your prescription at the pharmacy counter or receive a prescription in a medical facility. This creates an automatic claim, and the price you pay out of pocket factors in your insurance benefits.
If your insurance wasn’t checked when you filled your prescription and you paid full price out of pocket for a prescription, you can send us a claim and supporting documentation to get reimbursed under your coverage. You may need to work with your pharmacy or provider to get the necessary information to file your claim.
These are claims related to an FSA administered through HealthPartners.
If you have a HealthPartners insurance plan in addition to a HealthPartners-administered FSA, you’ll automatically receive a reimbursement equal to what you owe your provider out of pocket (after your insurance benefits are factored in). You can
You can also submit a manual claim to get reimbursed from your FSA if you didn’t use your HealthPartners insurance (or if you don’t have HealthPartners insurance). Your claim must be for
You must have sufficient funds in your FSA for any claim, automatic or manual, to process in full.
These are claims related to an HRA administered through HealthPartners.
If you have a HealthPartners insurance plan in addition to a HealthPartners-administered HRA, you or your provider will receive a reimbursement equal to what you owe your provider out of pocket (after your insurance benefits are factored in). You can
You can also submit a manual claim to get reimbursed from your HRA if you didn’t use your HealthPartners insurance (or if you don’t have HealthPartners insurance). Your claim must be for
You must have sufficient funds in your HRA for any claim, automatic or manual, to process in full.
Some of our group insurance plans through an employer or other organization include travel benefit coverage.
Under this benefit, when you or someone on your plan receives a covered medical service that isn’t available within a geographic distance specified by your plan, we’ll pay for eligible travel expenses – so long as the covered service was performed legally (according to local laws where the service took place) within the United States.
After you’ve completed the claim form, mail it and all required receipts to:
HealthPartners Member Claims
P.O. Box 1289
Minneapolis, MN 55440-1289
Not sure whether you have travel benefit coverage or what your plan’s requirements are? Contact your plan administrator, call Member Services at the number on the back of your member ID card, or
Additional resources
If you have additional questions about claims, call Member Services at the number on the back of your member ID card or
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