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Administrative policies

Administrative policies are available for providers delivering care to HealthPartners members.

  1. Access to Care & Services
  2. Accessibility to Utilization Mgmt Staff
  3. Advance Notice of Non-Coverage for Medicare members
  4. Affirmative Statement Regarding Incentives
  5. Anesthesia Payment Methodology
  6. Bundled Invasive Procedures in Ambulatory Surgery Center Settings
  7. Care Coordination for MSHO/MSC+
  8. Care Coordination for Special Needs Basic Care (SNBC)
  9. CIGNA/HealthPartners Alliance
  10. Claim Submission Requirements for Drug Codes (formerly J Code Submission on Claims)
  11. Clinical Practice Guidelines
  12. Complaint Reporting
  13. Continuity of Care Due to Employer Change in Health Plans
  14. Continuity of Care Following Termination of a Provider
  15. Coordination of Care, Provider Responsibility
  16. Credentialing Notifications
  17. Delegation Oversight for Care Coordination
  18. Diagnostic Imaging Provider Notification Program
  19. Disease Management
  20. Do Not Use Abbreviations & Error-prone Abbreviations
  21. Enrollee Rights - HealthPartners Care
  22. Essential Community Provider Contracts
  23. Equity, Inclusion, & Anti-Racism
  24. Fixed Wing Air or Rotary Wing Air Ambulance Transportation Provider Reimbursement
  25. GA Modifier on Claim Submissions
  26. GA, GY, or GZ Modifier on Claim Submissions for Medicare Plans
  27. Genetic & Molecular Lab Testing
  28. Home Care Bill of Rights–Minnesota Health Care Program
  29. Hospital Admission Notification Process
  30. Hospital, SNF, HHA, and CORF Notifications to Medicare Members
  31. Imaging Accreditation
  32. In-Network Benefit Requests for Out of Network Providers
  33. Intensive Obesity Counseling
  34. Interpreter Services
  35. Measuring and Reporting Provider Performance
  36. Medical Records Standards
  37. Medicare Responsibilities for Providers and HealthPartners
  38. Medication Therapy Management (MTM) Provider Participation Criteria
  39. Member Appeals Process for Public Programs
  40. Member Rights and Responsibilities
  41. Minnesota Care Tax
  42. Multiple Procedure Payment Reduction (MPPR) Rules-Facility Claims
  43. Multiple Procedure Payment Reduction (MPPR) Rules-Professional Claims
  44. Never Events
  45. Oncology Care Program Standards
  46. Patient-Provider Communication
  47. Pediatric Vision – HP Eyewear Collection
  48. Personal Care Assistance & Elderly Waiver Provider Requirements
  49. Pharmaceutical Sampling
  50. Physician Incentive Plan (PIP) Data and Surveys
  51. Practitioner Office Site Quality
  52. Preventing, Detecting & Reporting Fraud, Waste & Abuse
  53. Prescription Monitoring Program (PMP)
  54. Prior Authorization Review Process for Commercial Products
  55. Prior Authorization Review Process for Medicare & Medicaid Products
  56. Privacy Practices for Contracted Network Providers
  57. Provider Billing and Collection of Member Cost-Sharing for Medicaid Products
  58. Provider Communications
  59. Provider-Initiated Clinic Reassignment of Member
  60. Provider Portal Electronic Data Access
  61. Quality Case Reviews
  62. Quality Monitoring of Organizational Providers
  63. Rare Diseases or Conditions(Eff 01-01-2024)
  64. Reimbursement at Observation Level of Care for Specified Diagnoses
  65. Reimbursement for Services Provided by Pre-licensed Practitioners and Postdoctoral Fellows
  66. Referral Management: Provider Recommendation for Further Services
  67. Required Disclosure to Patients of Potential Bills from Providers
  68. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit
  69. Specialty Pharmacy Network Participation Requirements
  70. Standing Referral Process
  71. Telehealth Services
  72. Total Cost of Care and Patient Management Data Use
  73. Transition of Care When Benefits End
  74. Utilization Management Criteria Access
  75. Workers Compensation Certified Managed Care Plan