HealthPartners
Midlands Choice is the network option for all HealthPartners members who receive care in Iowa and Nebraska.
- 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.
Sample ID Card:
Please submit claims to the address indicated on the back of the ID card.
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)
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