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

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

1. Add-On Code G2211 (PDF)
2. Anesthesia Payment Methodology (PDF)
3. Anti-Fraud, Waste and Abuse Expectations (PDF)
4. Bundled Invasive Procedures in Ambulatory Surgery Centers Criteria and Standards for Providers (PDF)
5. Claim Submission Requirements for Drug Codes (PDF)
6. Critical Care Services When Patient Is Discharged to Home (PDF)
7. Diagnosis Coding Edits for Acute Stroke and Sepsis (PDF)
8. Fixed Wing Air or Rotary Wing Air Ambulance Transportation Provider Reimbursement (PDF)
9. GA Modifier on Claim Submissions (PDF)
10. GA, GY or GZ Modifier on Claim Submissions for Medicare Plans (PDF)
11. Genetic and Molecular Lab Testing (PDF)
12. High-Cost Medical Drugs (PDF)
13. Intraoperative Neuromonitoring (PDF)
14. Inpatient Hospital Readmissions (PDF)
15. Intensive Outpatient Programs (IOP) (PDF)
16. Interpreter Services (PDF)
17. Laboratory Services (PDF)
18. Minnesota Care Tax (PDF)
19. Modifier 22 Procedures (PDF)
20. Multiple Procedure Payment Reduction (MPPR) Rules – Facility Claims (PDF)
21. Multiple Procedure Payment Reduction (MPPR) Rules – Professional Claims (PDF)
22. Never Events (Adverse Health Care Events) (PDF)
23. Provider-Based Care Management Services (PDF)
24. Psychotherapy Services (PDF)
25. Reimbursement at Observation Level of Care (PDF)
26. Reimbursement of Services Provided to Minnesota Health Care Programs (MHCP) Enrollees (PDF)
27. Reimbursement for Services Provided by Pre-licensed Practitioners and Postdoctoral Fellows (PDF)
28. Services Incidental to Inpatient Stays (PDF)
29. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit (PDF)
30. Single-Dose Vial Billing Requirements: JZ/JW Modifier Codes (PDF)
31. Spravato® (Esketamine) (PDF)
32. Superficial Radiation Therapy (PDF)
33. Technology-Enabled Surgical Procedures (PDF)
34. Telehealth/Telemedicine Services (PDF)
35. Three-Dimensional (3D) Imaging Services (PDF)
36. Transabdominal, Transvaginal Ultrasounds (PDF)
37. Use of GK and GA Modifier on Claim Submissions for Hearing Aids (PDF)