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Effective 1/1/2017 Midlands Choice will be the network option for all HealthPartners members who receive care in Iowa and Nebraska. This previously was administered through Cigna.

What this means for you the provider:

• Providers who have both a HealthPartners and a Midlands Choice 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 contract with UnityPoint's ACO.
  • Iowa providers who do not have a direct contract with HealthPartners (or contract through UnityPoint's ACO) will be reimbursed at the Midlands Choice rate.
    • Questions regarding benefits for HealthPartners UnityPoint Health Members should be directed to HealthPartners Member Services. The number can be found on the member ID card.
  • Providers in Nebraska will be reimbursed at the Midlands Choice rate.
• Individuals who are able to access care through this strategic alliance will have an ID card issued 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.

 
 

Sample ID card: HealthPartners UnityPoint Health administration

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

 
 

HealthPartners plan administration

	HealthPartners & HealthPartners UnityPoint Health ID Cards
Online inquiries
Website to access Note: You will need to be a registered user to access most information.	HealthPartners website: HealthPartners.com/provider
Online inquiries 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 use for submitting claims electronically	Listing of EDI vendors HealthPartners.com/provider-public/edi/clearinghouses
Payer ID	HealthPartners.com/provider-public/edi/clearinghouses/
Transactions by telephone
• Verify patient eligibility and coverage • Check the status of a claim • Request precertification for services • Check credentialing status • Request an exception to the prescription drug list • Learn about electronic services	1.800.883.2177
Contact Provider Services	1.800.444.4558
Transactions by telephone
Payment appeal	1.800.444.4558
Clinical appeal	Refer to the contact information received on the authorization or denial letter

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