September 23, 2019
HealthRules Payor—New Claims Platform Implementation Delayed for Medicaid and Medicare
Health Partners Plans recently announced that we would be adopting a new claims processing platform called HealthRules Payor (HRP). This change is intended to improve our claims adjudication processes and ensure our claims processing system is current with today’s technology. Our stated target date was October 1, 2019.
We are moving forward with HRP for our KidzPartners (CHIP) product, effective October 1; however, we have decided to delay the implementation of HRP for our Health Partners (Medicaid) and Health Partners Medicare product lines.
HOW THIS AFFECTS CLAIMS PROCESSING AND CLAIMS RECONSIDERATIONS
For our CHIP product line, the transition to HRP will require a suspension of claims processing and real-time claims reconsiderations from Monday, September 23 through Sunday, September 29. There will be no CHIP payment during this week. Normal CHIP claims processing and payments will resume the following week.
For our Medicaid and Medicare products, claims processing and real-time claims reconsideration processing will remain unaffected for now. More information regarding the implementation date for Medicaid and Medicare will be shared soon.
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 that may affect you during this period.