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  • Complete An Appeal Form - Healthpartners

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HealthPartners Member Services 8170 33rd Avenue South P.O. Box 1309 Minneapolis, MN 55440-1309 (952) 883-5000 Dear Member/Member Representative: We want to help answer your questions and/or resolve.

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In HealthPartners' appeal guidelines, a provider has 60 days from the remit date of the original timely filing denial to submit an appeal. If the appeal is received after the 60 days, a letter will be sent to the provider stating the appeal was not accepted.

Appeal Form ing to state guidelines, you have 60 days from the date of service, adverse decision, or initial provider bill to request an appeal. Please complete this form to the best of your ability and return it by mail, email, fax, or by hand delivery.

The original claim must be received by the department within a maximum of 180 days after the date the services were rendered or compensable items provided.

Formal appeals must be submitted in writing (with formal appeal form) within 60 days of the adverse determination, when the requested service has been provided.

If you're asking for a reconsideration, you're not appealing. It's sort of a new claim, a reopened claim, whatever you want to call it. You've got to say, “I disagree” and now there's a form that you have to use.

Grievance: Concerns that do not involve an initial determination (i.e. Accessibility/Timeliness of appointments, Quality of Service, MA Staff, etc.) Appeal: Written disputes or concerns about initial determinations; primarily concerns related to denial of services or payment for services.

Call 952-883-5000 or 800-883-2177.

In HealthPartners' appeal guidelines, a provider has 60 days from the remit date of the original timely filing denial to submit an appeal. If the appeal is received after the 60 days, a letter will be sent to the provider stating the appeal was not accepted.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232