August 1, 2019
HealthRules Payor—New Claims Platform Coming October 1
Health Partners Plans will soon moving to a new claims processing platform: HealthRules Payor (HRP).
HRP will begin handling all claims processing for our Medicaid and CHIP product lines effective October 1, 2019, and for our Medicare product line by early 2020.
The HRP transition is necessary to bring our claims processing system current with today’s technology and will result in improvements to our claims adjudication processes.
We do not anticipate any significant issues related to the HRP transition. However, should there be any unintended impacts, our provider network team will issue additional communications and conduct outreach to affected providers as deemed necessary.
Additionally, we will conduct a data conversion process that will temporarily suspend claims processing and real-time claims reconsideration processing from September 23 through September 30. There will be no payment during this week, but normal claims processing and payments will resume the following week.
Please note that our Provider Services Helpline and Claim Reconsideration Call Center staff will be in training during the month of September, which will likely affect response times and turnaround times for claim reconsideration requests. Training of our staff is essential to the success of our HRP transition. We apologize in advance for this inconvenience.
We strongly encourage you to take advantage of our provider portals NaviNet and HP Connect to access member eligibility and benefits, check the status of claims and request claim reconsiderations (the turnaround time of claim reconsiderations will be affected by the staff training).
If you have any questions or concerns, please contact our Provider Services Helpline at 1-888-991-9023 (Monday–Friday, 9 a.m.–5:30 p.m.). We will keep you informed of any additional changes to this transition that may impact you, including the timeline as described in this letter.