Sign Up for the Provider E-Newsletter
Email:


11/18/2016

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