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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. Epidural Steroid Injection (ESI) Decision Support Program
  23. Essential Community Provider Contracts
  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(Eff 7-1-2021)
  28. Hospital Admission Notification Process
  29. Hospital, SNF, HHA, and CORF Notifications to Medicare Members
  30. Imaging Accreditation
  31. In-Network Benefit Requests for Out of Network Providers
  32. Intensive Obesity Counseling
  33. Interpreter Services
  34. Measuring and Reporting Provider Performance
  35. Medical Records Standards
  36. Medicare Responsibilities for Providers and HealthPartners
  37. Medication Therapy Management (MTM) Provider Participation Criteria
  38. Member Appeals Process for Public Programs
  39. Member Rights and Responsibilities
  40. Minnesota Care Tax
  41. Never Events
  42. Oncology Care Program Standards
  43. Patient-Provider Communication
  44. Pediatric Vision – HP Eyewear Collection
  45. Personal Care Assistance & Elderly Waiver Provider Requirements
  46. Pharmaceutical Sampling
  47. Physician Incentive Plan (PIP) Data and Surveys
  48. Practitioner Office Site Quality
  49. Preventing, Detecting & Reporting Fraud, Waste & Abuse
  50. Prior Notification for Spine Surgical Practice - Low Back Pain Office Visits
  51. Prior Authorization Review Process for Commercial Products (Revised 11-30-2020)
  52. Prior Authorization Review Process for Medicare & Medicaid Products (Revised 11-30-2020)
  53. Privacy Practices for Contracted Network Providers
  54. Provider Billing and Collection of Member Cost-Sharing for Medicaid Products
  55. Provider Communications
  56. Provider-Initiated Clinic Reassignment of Member
  57. Provider Portal Electronic Data Access
  58. Quality Case Reviews
  59. Quality Monitoring of Organizational Providers
  60. Referral Management: Provider Recommendation for Further Services
  61. Required Disclosure to Patients of Potential Bills from Providers
  62. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit
  63. Standing Referral Process
  64. Telehealth Services - Temporary COVID-19 (Revised 12-21-2020)
  65. Total Cost of Care and Patient Management Data Use
  66. Transition of Care When Benefits End
  67. Utilization Management Criteria Access
  68. Workers Compensation Certified Managed Care Plan