Each HealthPartners Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) member has an assigned Care Coordination. This page contains forms, guides, templates and clinical resources for MSHO/MSC+ Care Coordinators.

• DHS-3427T - LTC Screening Document -Telephonic
• DHS 3936 - My Move Plan Summary
• MSHO Unable to Reach and Decline Care Plans Workaid
• New Enrollee with PCA Workflow
• In Lieu of Services Work aid
• Initial Request for PCA Services
• PCA Request for Additional Hours
• PCA Annual Reassessment Workflow
• HP Pre-Admission Screen Process
• Unable to Reach and Decline Interdisciplinary Care Plan

• MSC+ Care Coordinator Change
• MSC+ Care Coordinator Introduction
• MSC+ Support Plan to Member
• MSC+ Support Plan to MD or Care Team
• MSC+ Unable to Reach
• MSC+ Member Services Support Plan Change
• MSHO/MSC+ Provider Support Plan Cover Letter
• MSHO Care Coordinator Change
• MSHO Care Coordinator Introduction
• MSHO Support Plan to Member
• MSHO Support Plan to MD or Care Team
• MSHO Member Services Support Plan Change
• MSHO NH Authorized Representative
• MSHO Unable to Reach
• MSHO UTR/Decline Support Plan to Member

• Bolger Order Form
• DHS Application Access Request
• DHS 5181 - Long Term Care (LTC) Communication Form [DHS-5181]
• DHS 5841 - Recommendation for State Plan Home Care Services[DHS-5841]
• DHS 6037 - Home and Community-Based Services (HCBS) Transfer & Communication Form [DHS-6037]
• DHS MMIS Data Entry Form
• DHS MMIS Data Entry Confidentiality Agreement
• HP Authorization to Disclose PHI
• HP Benefit Exception Inquiry Form
• HP Benefit Exception Instructions
• HP Denial Termination/Reduction (DTR) Form
• HP Denial Termination/Reduction Instructions
• HP Service Authorization Form

• EDI Portal link for reports
• Basic EDI Instruction Guide

• Clinical Care Planning Guide - Asthma
• Clinical Care Planning Guide - CAD
• Clinical Care Planning Guide - Chronic Pain
• Clinical Care Planning Guide - Diabetes
• Clinical Care Planning Guide - Eating Disorders
• Clinical Care Planning Guide -HTN
• Clinical Care Planning Guide - Mental Health
• Member Enrollment – Inquiries to Enroll in MSHO/MSC+
• Health Information Library
• Fast Track Interventions Skin Breakdown
• Fast Track Interventions UTI
• FBRxCobraandedBoxInsert
• FBRxCobraandedOutreachLetter
• Final Tivity Silver Sneakers
• Language & Interpreter Services
• MinnesotaHelp.Info
• Safe Disposal of Medications
• Safe Disposal of Medications Locations Flyer
• Safe Disposal of Prescription Medication Brochure
• SilverSneakers Member Flyer
• Silver Sneakers workaround to getting member 16 Digit ID
• MSHO Supplemental Benefits Bluestone
• ILS Authorization Guidelines
• PCA Network Listing
• Quick guide for Juniper referrers
• Juniper program descriptions
• Juniper tri-fold brochure

• MSHO Model of Care Training
• HealthPartners-Bluestone Care Coordination Update
• Silver Sneakers Overiew PPT
• MSHO Training Manual
• Presentation Provider Signature Requirement Training
• Webinar Presentation - HP Delegation training
• HSS Program Updates and MSHO Training

• HP Condition Resources – Alcohol and Risky Drinking
• HP Condition Resources – Depression
• Adult Mental Health Programs and Services, DHS
• Mental Health Association of MN
• National Alliance of Mental Illness
• National Institute on Alcohol Abuse and Alcoholism
• Substance Abuse and Mental Health Services, HHS

• RideCare & Spec. Transportation Exception Request Policy
• RideCare & Spec. Transportation Exception Request Form
• HealthPartners Fax Ride Request Form

• Chart Audit Protocols – DHS Care Plan Audit – Elderly Waiver
• Chart Audit Protocols – DHS Care Plan Audit – Non-Elderly Waiver
• Letter Attachment – Appeal Rights MSHO and MSC+
• Letter Attachment – Language Block MSC+
• Letter Attachment – Language Block MSHO
• Letter Attachment – Statement of Non-Discrimination Notice
• HP MSHO/MSC + Care Coordination Program
• HP MSHO/MSC + Delegation Oversight for Care Coordination
• HP Oversight of First Tier, Downstream and Related Entities (FDRs') Compliance