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. Anesthesia Payment Methodology
7. Bundled Invasive Procedures in Ambulatory Surgery Center Settings
8. Care Coordination for MSHO/MSC+
9. Care Coordination for Special Needs Basic Care (SNBC)
10. CIGNA/HealthPartners Alliance
11. Claim Submission Requirements for Drug Codes
12. Clinical Practice Guidelines
13. Complaint Reporting
14. Continuity of Care Due to Employer Change in Health Plans
15. Continuity of Care Following Termination of a Provider
16. Coordination of Care, Provider Responsibility
17. Credentialing Notifications
18. Delegation Oversight for Care Coordination
19. Diagnostic Imaging Provider Notification Program
20. Disease and Case Management Services(Commercial Products)
21. Disease and Case Management Services(Medicaid and Medicare Products)
22. Do Not Use Abbreviations & Error-prone Abbreviations
23. Enrollee Rights - Minnesota Health Care Programs
24. Essential Community Provider Contracts
25. Equity, Inclusion, & Anti-Racism
26. Fixed Wing Air or Rotary Wing Air Ambulance Transportation Provider Reimbursement
27. GA Modifier on Claim Submissions
28. GA, GY, or GZ Modifier on Claim Submissions for Medicare Plans
29. Genetic & Molecular Lab Testing
30. Home Care Bill of Rights–Minnesota Health Care Program
31. Hospital Admission Notification Process
32. Hospital, SNF, HHA, and CORF Notifications to Medicare Members
33. Imaging Accreditation
34. Intensive Obesity Counseling
35. Interpreter Services
36. Measuring and Reporting Provider Performance
37. Medical Records Standards
38. Medicare Responsibilities for Providers and HealthPartners
39. Medication Therapy Management (MTM) Provider Participation Criteria
40. Member Appeals Process for Public Programs
41. Member Rights and Responsibilities
42. Minnesota Care Tax
43. Multiple Procedure Payment Reduction (MPPR) Rules-Facility Claims
44. Multiple Procedure Payment Reduction (MPPR) Rules-Professional Claims
45. Network Adequacy Exception Request – Benefit Review
46. Never Events
47. Oncology Care Program Standards
48. Patient-Provider Communication
49. Pediatric Vision – HP Eyewear Collection
50. Personal Care Assistance & Elderly Waiver Provider Requirements
51. Pharmaceutical Sampling
52. Physician Incentive Plan (PIP) Data and Surveys
53. Practitioner Office Site Quality
54. Preventing, Detecting & Reporting Fraud, Waste & Abuse
55. Prescription Monitoring Program (PMP)
56. Prior Authorization Review Process for Commercial Products
57. Prior Authorization Review Process for Medicare Products
58. Prior Authorization Review Process for Medicaid Products
59. Privacy Practices for Contracted Network Providers
60. Provider Billing and Collection of Member Cost-Sharing for Medicaid Products
61. Provider Communications
62. Provider-Initiated Clinic Reassignment of Member
63. Provider Portal Electronic Data Access
64. Quality Case Reviews
65. Quality Monitoring of Organizational Providers
66. Rare Diseases or Conditions
67. Referral Management: Provider Recommendation for Further Services
68. Required Disclosure to Patients of Potential Bills from Providers
69. Self-administered Drugs Requiring Claim Submission on the Pharmacy Benefit
70. Specialty Pharmacy Network Participation Requirements
71. Standing Referral Process
72. Telehealth Services
73. Total Cost of Care and Patient Management Data Use
74. Transition of Care When Benefits End
75. Utilization Management Criteria Access

Reimbursement Policies

1. Inpatient Hospital Readmissions
2. Reimbursement at Observation Level of Care for Specified Diagnoses
3. Reimbursement for Services Provided by Pre-licensed Practitioners and Postdoctoral Fellows
4. Robotic Assisted Surgical Services