For Healthcare Providers:

HealthPartners

HealthPartners

Midlands Choice is the network option for all HealthPartners members who receive care in Iowa and Nebraska. This previously was administered through Cigna.

  • Providers who have both a HealthPartners and a Midlands contract will be reimbursed at the HealthPartners contracted rate.
    • Providers in the HealthPartners network in Iowa will be reimbursed at HealthPartners rates – this includes those providers who contracts with UnityPoint’s ACO.
    • Iowa providers who do not have a direct contract with HealthPartners (or contracts through UnityPoint’ s ACO) will be reimbursed at the Midlands Choice rate.
    • Providers in Nebraska will be reimbursed at the Midlands Choice rate.
    • Providers will need to verify eligibility online or by phone as network participation varies – see HealthPartners plan administration information below.
  • Individuals who are able to access care through this strategic alliance will have an ID card issued either by HealthPartners (or its related company HealthPartners UnityPoint Health).
Sample ID Card: HealthPartners Administration

Please submit claims to the address indicated on the back of the ID card.

HealthPartners ID Card Front 1HealthPartners ID Card Back 1
HealthPartners ID Card Front 2HealthPartners ID Card Back 2

Sample ID Card: HealthPartners UnityPoint Health Administration

Please submit claims to the address indicated on the back of the ID card.

HealthPartners ID Card Front 3HealthPartners ID Card Back 3
HealthPartners ID Card Front 4HealthPartners ID Card Back 4

Plan Administration

Online Inquires
Website to access
Note: You will need to be a registered user to access most information.
HealthPartners website: www.healthpartners.com/provider
Online inquires that can be performed
  • Verify patient eligibility and coverage
  • Check the status of a claim
  • Request precertification for services
  • View claim coding policies and payment guidelines
  • Review medical coverage positions
  • View the pharmacy formulary
  • Update address information
Electronic Data Interchange (EDI)
EDI transactions that can be performed
  • Verify patient eligibility and coverage
  • Inquire about patient coverage and covered services
  • Check the status of a claim
  • Request precertification for services
  • Submit claims electronically
  • Receive electronic remittance advices
Vendors to user for submitting claims electronically Listing of EDI vendors www.HealthPartners.com/provider-public/edi/clearinghouses/
Payer ID www.HealthPartners.com/provider-public/edi/clearinghouses/
Transactions by Telephone
  • Verify patient eligibility and coverage
  • Inquire about patient coverage and covered services
  • Check the status of a claim
  • Request precertification for services
  • Submit claims electronically
  • Receive electronic remittance advices
(800) 883-2177
Contact Provider Services (800) 444-4558
Transactions by Telephone
Payment Appeal (800) 444-4558
Clinical Appeal Refer to the contact information received on the authorization or denial letter.

HealthPartners Administrative Resources

HealthPartners Administrative Policies and Coverage Criteria for can be found on the HealthPartners.com website in the Provider portal section under Admin Tools or by following the links below:

Administrative Policies

Coverage Criteria