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Medical and Claim Payment Policy Library Now Available

Health Partners Plans has recently created a new Medical and Claim Payment Policy Library on our website.

The policies that you will find in this library will provide clarification on how Health Partners Plans manages our business. Medical Policies will provide the medical necessity criteria and coverage positions on topics such as medical services, procedures, DME, therapies, drugs, etc. Additionally, claims payment policies will provide the reimbursement rules as well as billing guidelines for timely and appropriate payment.

Medical and Claim Payment Policy Library

When necessary, new policies will be added and updated. You will receive notification of updates to the library via HPP Insider, our email notification tool.

Note: All policy documents are considered complimentary to the HPP Provider Manual.

Notification regarding our first two published policies

On October 1, 2015, our Ambulance Ground Mileage Claim policy (# 00.01) will become effective. The intent of this policy is to communicate the Health Partners Plans (HPP) reimbursement rules for ambulance ground mileage.

Additionally, we have published our Cosmetic Surgery policy (# 00.02). The intent of this claim payment policy is to communicate the Health Partners Plan (HPP) coverage position for Cosmetic Services. Although this policy document is available on the library as of August 18, 2015, the policy has been in effect since October 1, 2007.*

* The effective date of select policies found in the Policy Library above may considerably pre-date the actual date of their availability, in PDF format, on this new Policy Library web page. This is because the Policy Library will include PDFs of policies that have been in effect for many years, but until recently were not publically accessible.

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