To become a Hennepin Health provider, you will need to first complete a contract request form.* Be sure to include any unique services you offer or attributes you possess such as foreign languages spoken, transportation services offered, special populations you serve, etc. Once you submit the contract request form, it may take up to 90 days for it to be processed. You will receive a written response with our decision. If your request is approved, additional information and/or forms may be requested. Current proof of insurance with county required coverage also must be submitted prior to contract execution.
As of January 1, 2015, Hennepin Health is no longer accepting requests for personal care assistant (PCA) providers. If you submit a request and are a PCA provider, you will receive a denial.
Contract request forms should either be faxed to 612-632-8830 or mailed back to Hennepin Health at:
Minneapolis Grain Exchange Building
400 South Fourth Street, Suite 201
Minneapolis, MN 55415
*Submitting an initial credentialing application does not constitute as a contract request. The contract request form must be submitted to initiate application process.