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

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

Reimbursement Policies

1. Anesthesia Payment Methodology
2. Bundled Invasive Procedures in Ambulatory Surgery Center Settings
3. Claim Submission Requirements for Drug Codes
4. Fixed Wing Air or Rotary Wing Air Ambulance Transportation Provider Reimbursement
5. GA Modifier on Claim Submissions
6. GA, GY, or GZ Modifier on Claim Submissions for Medicare Plans
7. Genetic & Molecular Lab Testing
8. Intraoperative Neuromonitoring
9. Intraoperative Neuromonitoring(Eff 05-1-2025)
10. Inpatient Hospital Readmissions
11. Intensive Outpatient Programs (IOP)
12. Interpreter Services
13. Minnesota Care Tax
14. Modifier 22 Procedures
15. Multiple Procedure Payment Reduction (MPPR) Rules-Facility Claims
16. Multiple Procedure Payment Reduction (MPPR) Rules-Professional Claims
17. Never Events
18. Reimbursement at Observation Level of Care for Specified Diagnoses
19. Reimbursement of services provided to Minnesota Health Care Programs (MHCP) enrollees
20. Reimbursement for Services Provided by Pre-licensed Practitioners and Postdoctoral Fellows
21. Robotic Assisted Surgical Services
22. Services Incidental to Inpatient Stay
23. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit
24. Spravato® (esketamine)
25. Telehealth Services
26. Use of GK and GA Modifier on Claim Submissions for Hearing Aids