Servicing you with the most current information available on new and existing HealthPartners products and information specific to dental care.

We are pleased to announce that we have recently signed an agreement with National Electronic Attachment, Inc. (NEA) to start receiving electronically transmitted attachments such as x-rays, EOBs, perio charting, etc. to support your electronic claims.

• Accidental dental authorization form (PDF)
• Clinic address change form (PDF)
• Clinic Legal or Marketing name change form (PDF)
• Claim Attachment Fax Form - Dental (PDF)
• Clinic Ownership Change Notice (PDF)
• Credentialing Application (PDF)
• Dental Provider Change Notice (PDF)
• Fee Schedule Form (PDF)
• HealthPartners Dental Contracted Provider Manual (PDF)
• HealthPartners Dental Provider Office Questionnaire (PDF)
• Prior Notification of Diabetes or Pregnancy Form (PDF)
• W-9 form for Tax Id Changes (PDF)

• Disclosure of Ownership Statement (PDF)
• HealthPartners Care Dental Benefit Guide (PDF)
• HealthPartners Care Waiver for Non Covered Dental Services (PDF)
• MSHO Model of Care (PDF)

Contact the dental network team at dentalcontracting@healthpartners.com or call 952-883-6163.