What is HealthPartners process to become an in-network provider?

Contracting is a separate and distinct process from practitioner credentialing and enrollment. Both are required to participate in our network.

• Contracting is the formal process of obtaining a provider network agreement.
• Practitioner credentialing and enrollment is the formal process for ensuring network practitioners are qualified to treat our members.

Visit the Join our network for more detailed information on becoming a network provider.

How do I check the status of my network participation request?

Contracting requests are managed by the HealthPartners Contracting and Payer Relations department. To check the status of your contracting request please contact Contracting and Payer Relations by clicking the link below.

• Check status of a contract request

What are your provider credentialing and enrollment requirements?

Before practitioner credentialing or enrollment can begin, you must be a contracted provider or have been offered a contract by HealthPartners. Once individual practitioners have enrolled with DHS, all EIDBI providers must complete either our provider credentialing or enrollment process below.

• Review credentialing resources at Credentialing and enrollment

How do I check if a patient is currently insured with HealthPartners and eligible for EIDBI Services?

1. Prior to services being rendered and obtaining a service authorization, utilize the Eligibility Inquiry tool in the HealthPartners Provider Portal to obtain: policyholder, coverage and benefit details, coverage criteria and more.
2. HealthPartners has established several non-participating trading partner connections for the exchange of eligibility inquiry and response transactions (270/271) through fast batch and real-time mode.
3. Please contact the following non-participating trading partners to determine what services are offered and any costs incurred in establishing and maintaining a connection with these vendors. HealthPartners does not pay for fees associated to this transaction.

• Register Now
• Providers are required to contact these intermediaries directly to enroll for all electronic transactions to HealthPartners.
• You may also call our HealthPartners Member Services Department to obtain eligibility & benefit information.

What are HealthPartners prior authorization requirements for EIDBI services?

Authorization process:

• View the HealthPartners EIDBI policies:
  • Autism - early intensive developmental and behavioral intervention (EIDBI) – Minnesota Health Care Programs - Authorization requests are reviewed by Behavioral Health Utilization Management department.
  • Physical Therapy/Occupational Therapy - Authorization requests are reviewed by Medical Utilization Management Department.
• How to submit a request for authorization:
  • Fax required clinical to 952-853-8830
• How long does it take for authorization review?
  • HealthPartners has 14 days to make a decision about a request. However, if we have all the necessary clinical we will have a decision in 2 or 3 days.
• What documents are required for authorization review?
  • Comprehensive Multi-Disciplinary Evaluation (CMDE)

How do I bill HealthPartners for EIDBI Services:

1. HealthPartners requires all claims to be submitted to us electronically. Providers can visit our e-Services page to learn more on how to register with HealthPartners to submit electronic claims.
2. Please bill HealthPartners for your EIDBI services following the guidelines contained on DHS’s EIDBI Billing Grid.
3. Helpful Tips for billing EIDBI services

If I am out of network, what is HealthPartners process for EIDBI Services?

• Submit an authorization request to our Behavioral Health Utilization Mgmt Department
• Fax required clinical to 952-853-8830
• Behavioral Health reviewer will first determine if the member meets criteria for EIDBI services.
• If the member meets criteria, then a provider search will be done to see if any in network providers have openings to see the member.
• If there are in network providers with openings, the reviewer will work with the member and family to receive care in network. 
• If there are no openings with our in network providers, we would most likely approve the request.
• Once the authorization is approved, you may begin submitting claims for the patient.
• If you would like to be an in-network provider please use this form to apply.

If I have additional questions, who at HealthPartners should I contact?

Visit our Contact us page for additional assistance.