Provider Education Self-Management Tools Certificate Program

These online classes were created to keep you informed on a variety of important topics. Complete an online course and receive a printable certificate of completion. Complete three courses and we will acknowledge your practice in our quarterly newsletter. (Please note: one of the courses must be the Provider Annual Orientation and Training). Click on a course below to start.

Provider Orientation and Training Providers who are contracted with Health Partners Plans (HPP) must demonstrate that they are knowledgeable and trained on important topics annually. Participation in our quarterly provider orientation and training course satisfies this annual requirement. The course offers a detailed overview of HPP and gives valuable information to meet the needs of our members. Topics include: claims information, member ID cards, on-line tools and prior authorization guidelines.

Timely Filing Protocols and The Reconsideration Process This course provides an overview of Health Partners Plans (180) calendar day process for submitting or resubmitting Claims for proper review and/or processing within an accurate Time Frame. Also provided is an overview of the Claims Reconsideration Appeals process with the steps and appropriate documentation needed for review and determination.

Cultural Competency and Linguistic Requirements and Services During this course you’ll learn how to access our clinical programs and resources for patients, including: • Identification and appropriate referral for mental health • Drug and alcohol and substance abuse services • Sensitivity training on diverse and Special Needs populations such as persons who are deaf or hard of hearing • How to obtain sign language interpreters and how to work effectively with sign language interpreters. Also Cultural Competency and Treating Special Needs populations, including the right to treatment for individuals with disabilities.

Complaints, Grievances and Medical Necessity Reviews Part 1 of this course offers information to providers regarding the Medicaid and CHIP Member Complaint and Grievance process, and how providers can submit Complaint and Grievance requests to the Plan on behalf of their patients who are Plan members. Part 2 of this course offers information to providers regarding the Medicaid and CHIP Member Utilization Management Authorization request process, and the need to provide supporting clinical documentation and orders required for a medical necessity review.