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

1. Access to Care & Services
2. Access to Doula Services for Pregnant People
3. Accessibility to Utilization Mgmt Staff
4. Advance Notice of Non-Coverage for Medicare members
5. Affirmative Statement Regarding Incentives
6. Care Coordination for MSHO/MSC+
7. CIGNA/HealthPartners Alliance
8. Clinical Practice Guidelines
9. Complaint Reporting
10. Continuity of Care Due to Employer Change in Health Plans
11. Continuity of Care Following Termination of a Provider
12. Coordination of Care, Provider Responsibility
13. Credentialing Notifications
14. Delegation Oversight for Care Coordination
15. Diagnostic Imaging Provider Notification Program
16. Disease and Case Management Services(Commercial Products)
17. Disease and Case Management Services(Medicaid and Medicare Products)
18. Do Not Use Abbreviations & Error-prone Abbreviations
19. Enrollee Rights - Minnesota Health Care Programs
20. Essential Community Provider Contracts
21. Equity, Inclusion, & Anti-Racism
22. Home Care Bill of Rights–Minnesota Health Care Program
23. Hospital Admission Notification Process
24. Hospital, SNF, HHA, and CORF Notifications to Medicare Members
25. Imaging Accreditation
26. Intensive Obesity Counseling
27. Measuring and Reporting Provider Performance
28. Medical Records Standards
29. Medicare Responsibilities for Providers and HealthPartners
30. Medication Therapy Management (MTM) Provider Participation Criteria
31. Member Appeals Process for Public Programs
32. Member Rights and Responsibilities
33. Network Adequacy Request – Benefit Review
34. Offshore Attestation
35. Oncology Care Program Standards
36. Patient-Provider Communication
37. Pediatric Vision – HP Eyewear Collection
38. Personal Care Assistance & Elderly Waiver Provider Requirements
39. Physician Incentive Plan (PIP) Data and Surveys
40. Practitioner Office Site Quality
41. Practice Requirements for Network EIDBI Providers
42. Preventing, Detecting & Reporting Fraud, Waste & Abuse
43. Prescription Monitoring Program (PMP)
44. Prior Authorization Review Process for Commercial Products
45. Prior Authorization Review Process for Medicare Products
46. Prior Authorization Review Process for Medicaid Products
47. Privacy Practices for Contracted Network Providers
48. Provider Billing and Collection of Member Cost-Sharing for Medicaid Products
49. Provider Communications
50. Provider-Initiated Clinic Reassignment of Member
51. Quality Case Reviews
52. Quality Monitoring of Organizational Providers
53. Rare Diseases or Conditions
54. Referral Management: Provider Recommendation for Further Services
55. Required Disclosure to Patients of Potential Bills from Providers
56. Specialty Pharmacy Network Participation Requirements
57. Standing Referral Process
58. Total Cost of Care and Patient Management Data Use
59. Transition of Care When Benefits End
60. Utilization Management Criteria Access

Reimbursement Policies

1. Add-On Code G2211
2. Anesthesia Payment Methodology
3. Bundled Invasive Procedures in Ambulatory Surgery Center Settings
4. Claim Submission Requirements for Drug Codes
5. Fixed Wing Air or Rotary Wing Air Ambulance Transportation Provider Reimbursement
6. GA Modifier on Claim Submissions
7. GA, GY, or GZ Modifier on Claim Submissions for Medicare Plans
8. Genetic & Molecular Lab Testing
9. High-Cost Medical Drugs
10. Intraoperative Neuromonitoring
11. Inpatient Hospital Readmissions
12. Intensive Outpatient Programs (IOP)
13. Interpreter Services
14. Laboratory Services
15. Minnesota Care Tax
16. Modifier 22 Procedures
17. Multiple Procedure Payment Reduction (MPPR) Rules-Facility Claims
18. Multiple Procedure Payment Reduction (MPPR) Rules-Professional Claims
19. Never Events
20. Provider-Based Care Management Services
21. Psychotherapy Services
22. Reimbursement at Observation Level of Care for Specified Diagnoses
23. Reimbursement of services provided to Minnesota Health Care Programs (MHCP) enrollees
24. Reimbursement for Services Provided by Pre-licensed Practitioners and Postdoctoral Fellows
25. Robotic Assisted Surgical Services
26. Services Incidental to Inpatient Stay
27. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit
28. Spravato® (esketamine)
29. Superficial Radiation Therapy
30. Transabdominal, Transvaginal Ultrasounds
31. Telehealth Services
32. Use of GK and GA Modifier on Claim Submissions for Hearing Aids