Provider Manual

Provider Manual Chapters

  1. Introduction (pdf)
  2. Rights and Responsibilities of Physicians and Providers (pdf)
  3. Provider Network Resources (pdf)
  4. Provider Billing (pdf)
  5. Credentialing and Organizational Assessment (pdf)
  6. Service Authorizations & Notification Standards (pdf)
  7. Clinical Practice Guidelines (pdf)
  8. Fraud and Abuse (pdf)
  9. Clinic Complaint Reporting Process (pdf)
  10. Model of Care (pdf)
  11. Sample Member ID Cards (pdf)
  12. Member Enrollment (pdf)
  13. Member Grievances and Appeals Process for Dual-Eligible Special Needs Programs (pdf)
  14. Member Grievances and Appeals Process for Minnesota HealthCare (Medicaid) Programs (pdf)
  15. Restricted Recipient Program (pdf)
  16. Wellness Programs (pdf)
  17. Child and Teen Checkups (C&TC) Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Program (pdf)
  18. Durable Medical Equipment and Supplies (pdf)
  19. Chiropractic and Acupuncture Services (pdf)
  20. Dental Services (pdf)
  21. Pharmacy Services (pdf)
  22. Mental Health & Substance Use Disorders Services (pdf)
  23. Personal Care Assistant (PCA) Services (pdf)
  24. Home Health Care/Hospice Services (pdf)
  25. Optical Services (pdf)
  26. Interpreter Services (pdf)
  27. Transportation Services (pdf)
  28. Critical Access Hospital (CAH) (pdf)
  29. Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) (pdf)
  30. Long-Term Care (LTC) (pdf)
  31. Immunizations and Vaccinations (pdf)
  32. Home and Community Based Services - Elderly Waiver (pdf)
  33. Telehealth (pdf)
  34. Housing Stabilization Services (pdf)
  35. School-based Community Services (pdf)
  36. Early Intensive Developmental and Behavioral Intervention (EIDBI) Services
  37. Minnesota Provider Screening and Enrollment
  38. Physician and Professional Services
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