Notice To Service Provider In Hennepin
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
Call us. Call 612-348-3000, Monday through Friday, 8 a.m. to p.m.
Hennepin Health's health plan receives per-member per-month Medicaid payments to cover the costs of medical, dental, and behavioral health services as well some care coordination services.
In MN the marketplace is called MNsure. To shop on MNsure, you must be a legal resident of MN, live in the service area of the health plan you are purchasing, and not be incarcerated. Initial open enrollment will be 10/1/13 – 3/31/14. Subsequent annual open enrollment will be in the fall.
Residents. Information and services. Conservation. Elections. Emergencies. Health and medical. Human services. Libraries. Licenses, certificates and permits. Property. Public safety and law. Recreation. Recycling and hazardous waste. Transportation.
Avivo currently provides long-term and short-term case management for recipients in Hennepin County, and offers short-term services additionally for clients in Anoka and Dakota Counties. For questions or to learn how to connect to services, email Ashley Schulte-Herman at tcm.intake@avivomn or call 612.210. 1393.
Call us. Call 612-348-3000, Monday through Friday, 8 a.m. to p.m.
Call the non-emergency line for Hennepin County Dispatch at 952 258 5321.
What are the claims submission payer ID's? Please use payer ID 60058 to send claims directly to Hennepin Health's claims preprocessor, Availity.
