The referral requirements for accessing out-of-network providers differ between the ACO defined partnership network and in-network non-ACO partner providers. This FAQ provides tips and answers common questions.
Shannon Mayer, CEO of Hennepin Health since April 2014, is leaving Hennepin Health to take a new position with another Minnesota health plan. Her last day at Hennepin Health is Friday, April 20, 2018.
Hennepin Health is required by the Minnesota Department of Human Services to have a grievance system in place that includes grievances, appeals, DTRs and state fair hearings. Effective January 1, 2018, some changes to the grievances, appeals and state fair hearings processes will take place.
Effective February 1, 2018, Hennepin Health will require ASC providers to submit claims utilizing the 837I transaction. If a claim is received on or after this date from an ASC provider utilizing the 837P transaction, it will be denied.
Hennepin Health has completed its 2017 annual HEDIS measure reporting. Results are available in the accompanying PDF document.
At this time, Hennepin Health’s provider network is closed for all provider types except chiropractic, acupuncture, federally qualified health centers and essential community providers.
Effective January 1, 2018, all pharmacy locations at the following retail stores will no longer be in Hennepin Health’s pharmacy network:
Effective January 1, 2018, EIDBI Level III providers will be required to enroll with the Minnesota Department of Human Services for Minnesota Health Care Programs.
Hennepin Health recently made updates to the electronic remittance advice. These changes are a result of new business processes and ensure Hennepin Health’s electronic remittance advices comply with ANSI Version 5010A1 835 requirements specified in the Technical Report Type 3.
Hennepin Health has confirmed that the 2018 updates to the International Classification of Diseases, Tenth Edition (ICD-10) released from the Centers for Medicare and Medicaid Services (CMS) are in effect with our claims processing vendor. This system update includes both ICD-10 CM and ICD-10 PCS. Claims for dates of services starting October 1, 2017 through September 30, 2018 are to be coded with this most recent code release.
Hennepin Health identified an error on the Remittance Advice published October 11, 2017. The claim adjustment reason code on all primary paid claims was reported as OA-23. This adjustment reason code should have reported as CO-45.
The MN Department of Human Services has made several changes to the Child and Teen Checkup (C&TC) schedule of periodic screenings and well-child examinations that went into effect on October 1, 2017.
Hennepin Health members can get flu shots through the pharmacy network in addition to the clinical setting. Attached is the Navitus-contracted pharmacy network where members are able to get a flu shot.
Based on feedback received from providers who utilize the Hennepin Health provider portal, several enhancements are being made to improve efficiency when using the system. These changes are outlined below, including snapshots of how the screens will look when the changes take effect on September 29, 2017.
As part of a collaborative PIP, UCare, HealthPartners, Medica, Blue Cross and Blue Shield of MN, and Hennepin Health with support from Stratis Health have teamed up to reduce disparity in antidepressant medication adherence by focusing attention on multiple interventions, including a provider toolkit.
Hennepin Health made several Q3 changes to its drug formulary applicable to all members.
Two new screenings have been added to the Minnesota Newborn Screening Panel effective August 1, 2017.
This webinar will discuss trauma in communities of color. The focus will be on delivering quality mental health services in a culturally appropriate way, and understanding the barriers and solutions in serving this population.
Effective 9/1/17, Hennepin Health is encouraging providers to submit claims with CPT Category II codes, which will simplify data collection for the purposes of performance measurement.
Hennepin Health has completed its first quarterly fee schedule update process and the July 2017 DHS fee schedule became effective August 15, 2017.
In line with the Minnesota Department of Human Services (DHS), Hennepin Health will implement a rate increase of 1.642% for PCA services. The new rate will apply to dates of service on or after January 1, 2018. Please contact Hennepin Health Member Services at 612-596-1036 (select the provider services option) with any questions.
The 120-day window to transition to in-network providers for members who transitioned to Hennepin Health from Medica on May 1, 2017 will be closing on August 28, 2017.
Hennepin Health has made several Q2 changes to its drug formulary applicable to Hennepin Health-MNCare, Hennepin Health-PMAP and Hennepin Health-SNBC members.
In this webinar, NAMI Minnesota will talk about risk factors, warning signs, stigma, treatment, recovery and resources for anxiety in older adults.
Effective July 1, 2017, Hennepin Health will update both the DHS and CMS monthly fee schedules on a quarterly basis unless regulatory requirements dictate a different timeline. This change applies to all Hennepin Health products and providers.
In this webinar, NAMI Minnesota will talk about risk factors, warning signs, stigma, treatment, recovery and resources for depression in older adults.
Effective May 4, 2017, all inpatient notifications and authorization requests should be faxed to Hennepin Health at 612-288-2878. Please update your contact information to reflect this new number. The inpatient services notification/authorization request can be accessed online.
Effective May 1, 2017, Medica will no longer be a health plan option for Hennepin County residents with Medical Assistance or MinnesotaCare, which means Hennepin Health will see a significant increase in its PMAP and MNCare membership as of this date. Hennepin Health is committed to ensuring that all new members - as well as providers - experience a smooth transition.
Personal care assistant (PCA) services are available for new Hennepin Health-PMAP and Hennepin Health-MNCare members transitioning from Medica.
Effective May 1, 2017, Hennepin Health made several changes to its drug formulary applicable to all members.
Hennepin Health recently completed a focused study on pain management, and pain medication prescribing and treatment.
Hennepin Health is pleased to announce the addition of Children’s to its PMAP/MNCare network effective April 1, 2017.
Effective May 1, 2017, Medica will no longer be a health plan option for Hennepin County residents with Medical Assistance or MinnesotaCare (MNCare), which means Hennepin Health will see a significant increase in its PMAP and MNCare membership as of this date.
This webinar will discuss the delivery of mental health services to the Latino population. The focus will be on delivering these services in a culturally appropriate way, and better understanding the barriers and solutions to providing this population with quality mental health services.
Effective 2/1/17, transaction file names will change for Electronic Data Interchange (EDI) 837I, 837P and 835 transactions.
Hennepin Health’s Quality Management Committee formally adopted nine medical practice guidelines from the Institute for Clinical Systems Improvement, the United States Preventive Services Task Force and the Minnesota Community Measurement D 5 (Diabetes) Program for 2017.
Hennepin Health has made several changes to its drug formulary that will become effective on February 1, 2017.
This is the fourth and final webinar in Dr. Kroupin's series that has explored the refugee experience as it relates to behavioral health. This session will focus on working with interpreters as part of the clinical team and the therapeutic process of treating behavioral health issues in refugees.
The antidepressant medication management provider toolkit is part of a performance improvement project that’s a collaborative effort among Blue Cross, HealthPartners, Hennepin Health, Medica and UCare with project support provided by Stratis Health.
Studies have shown that language barriers can make it difficult for patients to understand their medications, which is why it's critical that pharmacies provide translation services or have translated information available for non-English speaking patients.
The technical difficulties providers are currently experiencing with their TMG Provider Portal accounts should be resolved by Friday, October 28. Please contact us at 612-596-1036 with any questions or for further assistance.
In a continued response to an introductory webinar in February, health care professionals are invited to join a third webinar featuring Dr. Kroupin that will further explore the refugee experience as it relates to behavioral health.
Hennepin Health implemented three new upfront editing processes on August 1, 2016 that will go into effect on November 1, 2016.
Following MHP's recent name change to Hennepin Health, member ID cards for Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin-Health SNCB were updated to reflect the new visual identity.
Effective September 2, 2016, MHP changed its name to Hennepin Health and also introduced a new naming convention for its products, which will now be referred to as Hennepin Health-PMAP (formerly Hennepin Health), Hennepin Health-MNCare (formerly Hennepin Health) and Hennepin Health-SNBC (formerly Cornerstone Solutions). With this name change comes a refreshed visual identity, including a new logo.
As of July 1, 2016, eligible members are able to receive behavioral health home benefits.
In response to Dr. Kroupin's introductory webinar in February, health care professionals are invited to join a second webinar featuring him that will further explore the refugee experience as it relates to behavioral health.
Health care professionals are invited to join an upcoming webinar that will focus on depression care for Somali Americans.
A slight delay in the delivery of the 835 remittance advice file to the providers’ clearinghouse impacted claims processed and paid during the week of June 6, 2016.
The Minnesota Department of Human Services has published a new mental health rate sheet for adult rehabilitative mental health services, assertive community treatment, intensive rehabilitation treatment services and targeted-case management services.
Health care professionals are invited to join an upcoming webinar that will focus on behavioral health care for refugees.
MHP has made several changes to its drug formulary that will become effective on June 1, 2016.
Effective April 15, 2016, Hennepin Health will require injectable drugs commonly administered in an outpatient setting to be billed using a J code.
Questions about the new provider portal? Check out the updated FAQ for answers!
New Hennepin Health enrollees are assigned member and group numbers that will identify them as Hennepin Health members.
The 2016 Hennepin Health and Cornerstone Solutions formularies are now available.
Beginning December 31, 2015, MHP will use McKesson Payer Connectivity Services™ to provide member eligibility services.
Provider InSite will be decommissioned at the end of December 2015.
MHP oversees Cornerstone Solutions (SNBC) members' access to emergent, urgent and preventive care by conducting an annual survey of its contracted mental health providers.
MHP's call center will be closed on Thursday, 11/26 for Thanksgiving, but will be open on Friday, 11/27 from 8 a.m. to 4:30 p.m.
Hennepin Health will continue to offer an open access network for mental health and chemical health services in 2016.
A reminder to submit your 2015 Q1 claims and claim adjustment requests/reconsiderations!
Health care professionals are invited to join an upcoming webinar that will focus on shared decision-making and depression treatment in primary care.
Questions about ICD-10 codes? Check out the FAQ for answers!
Hennepin County substitute W9 form
Questions about the new provider portal? Check out the FAQ for answers!
MHP provider portal to go live
MHP is collaborating with other health plans on a PIP to improve antidepressant medication management in Minnesota.
New claims processing system service authorizations
This week MHP began processing claims in the new claims system.
Elimination of paper remittance advices and claims
MHP’s Quality Management Committee formally adopted nine medical practice guidelines in March 2015.
MHP has updated its member and provider materials to clarify the policy regarding eyeglass benefits.
An error was made in the September 2014 edition of Provider Focus pertaining to the timing requirements of the provider appeal process.
MHP's transportation policy has been updated to reflect the current protocol for transporting members to a pharmacy.
Last month, MHP debuted a new website that is more user friendly and supportive of MHP’s users’ needs, and reflective of MHP’s unique brand and identity.
MHP Transitions to a New Health Claims Payment System (Part 2)
Provider Focus is a quarterly newsletter for MHP providers.
Centers for Medicare and Medicaid Services (CMS) Current Procedural Terminology (CPT) 59 Modifier Changes
Survey results for McLeod Social Service Center, Mental Health Resources, Inc., Quality Case Management, Inc. and Tasks Unlimited.