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FREQUENTLY ASKED QUESTIONS

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I WANT TO OPEN A PRIVATE PRACTICE, AND I HAVE NO IDEA WHERE TO START, HELP!

We recommend doing the following steps first before you reach out to insurance companies for contracts: 

  1. Go to your board's website and make sure you file as a firm.  This is a step that is often overlooked and can have financial penalties.

  2. Get an NPI II for your entity on the NPPES website - this will make it much easier in the long run to add clinicians, should you decide to hire an employee or a contractor

  3. Get a Tax ID Number from the IRS - this is free on the IRS website.  If you would like to enroll as a provider with Medicare, make sure your practice address is the same as the legal entity address you have registered with the IRS - Medicare will require this. 

  4. Register your LLC with the State of Minnesota, also register a DBA name with the State of Minnesota if you are opting to use a different business name than the one you originally filed with

  5. Get a business bank account.  Your business bank account will need to have the same address as your practice if you intend to enroll with Medicare

  6. Make sure you have active professional liability insurance and general commercial liability insurance.  The required limits are $1,000,000 per occurrence, $3,000,000 aggregate.  General Commercial Liability coverage is required by Ucare, but not the other payers, so if you do not wish to contract with Ucare, you do not have to add this.

  7. Establish a business website, administrative phone number, and email address

  8. Make sure your psychology today profile and business website highlight the niche diagnoses and populations you work with

WHAT PAYERS ARE OFFERING OR NOT OFFERING CONTRACTS RIGHT NOW IN THE STATE OF MINNESOTA? HOW MUCH DO THEY REIMBURSE?

The following payers are offering contracts - Fee Schedules are Not Negotiable: 

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1. Minnesota Health Care Programs (MHCP - straight Medicaid). The MHCP Mental Health fee schedule is publicly available on the DHS website.   

2. Ucare (will not contract for telehealth only) - fee schedule is based on MHCP MH fee schedule

3. Optum (the Optum umbrella includes UBH, UHC, UMR, UHC PMAP, Medica) - Optum periodically does rate reviews of their own accord, and may increase rates upon review.  The fee schedule will be included in your contract.

4. Hennepin Health

5. South Country Health Alliance

6. BCBS - you may request a fee schedule

7. HealthPartners - the fee schedule will be sent with the contract draft

8. Aetna - the fee schedule will be included in the contract

9. Medicare 

10. Tricare (through TriWest)

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Please note it is against the law for us (and contract holders) to discuss specifics about practice contracts, including fee schedules. 

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HOW LONG DOES IT TAKE TO GET CONTRACTED WITH EACH PAYER?​

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Payer (Minnesota Based Networks Only)

Approximate Timeline from Submission

 

Aetna

90-120 days (requires current CAQH profile)

 

BCBS of Minnesota and Blue Plus PMAP

90-120 days (cannot apply until DHS approves)

 

HealthPartners Commercial and PMAP

150-180 days (cannot apply until DHS approves)

 

Hennepin Health

60-90 days

 

MN DHS - Medicaid

30-45 days

 

Medicare

30-60 days

 

Optum group (UHC, UBH, Medica, UMR, UHC PMAP, Medica PMAP, Bind/Surest)

30-60 days

 

South Country Health Alliance

90-120 days

 

Tricare

New contracting vendor for 2025, currently the timeline is unknown.

 

Ucare Commercial and Ucare PMAP

90-120 days (cannot apply until DHS approves)

Ucare requires general commercial liability insurance in addition to professional liability insurance.  Please ensure your insurance certificate lists both professional liability insurance AND general commercial liability insurance in the 1 mil / 3 mil limits.

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WHAT IS MINNESOTA CARE TAX?

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It is the responsibility of the provider/provider group to track and pay MN Care Tax according to the tax payment schedule and deadlines identified in accordance with the Minnesota Department of Revenue and to maintain compliance.  Please contact the Minnesota Department of Revenue, and/or your CPA, to inquire further about how to manage this correctly. https://www.revenue.state.mn.us/minnesotacare-taxes

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