Is Institutional Care Program Paid by Check or EFT? Understanding Provider Payment Options with Minnesota Health Care Programs

Navigating the payment processes for institutional care programs can be complex, especially for healthcare providers. Minnesota Health Care Programs (MHCP) offers clarity and efficiency in its payment methods for enrolled providers. This guide explains how institutional care and other healthcare services are compensated by MHCP, focusing on whether payments are issued by check or Electronic Funds Transfer (EFT). Understanding these payment options is crucial for providers participating in MHCP and ensuring timely and secure reimbursement for their services.

MHCP Enrollment: Your First Step to Receiving Payments

To receive payments from MHCP for institutional care or other healthcare services, providers must first be enrolled in the program. MHCP provides comprehensive resources and guidance for enrollment through the Minnesota Provider Screening and Enrollment (MPSE) portal. For those new to MHCP, quarterly webinars are available to walk providers through the initial enrollment process using the MPSE portal. Registration for these valuable training sessions can be found on the MPSE training website.

The enrollment process involves several key steps to ensure compliance and eligibility:

Verifying Exclusion Lists

Before beginning the enrollment process, providers must check both federal and state excluded provider lists. This is a critical step as MHCP is prohibited from enrolling or paying providers who, or whose employees or contractors, are excluded from participation in federal healthcare programs like Medicare and Medicaid. The Office of Inspector General (OIG) maintains a List of Excluded Individuals and Entities (LEIE) which must be checked:

Prior to initiating enrollment.
Before hiring new staff or contracting with new entities.
Regularly, at least monthly, to monitor for any updates.

Any exclusions discovered must be reported to MHCP Provider Eligibility and Compliance immediately via fax at 651-431-7462. Further information can be found on the Excluded Provider Lists page within the MHCP Provider Manual.

Meeting MHCP Requirements

Eligibility for MHCP enrollment requires providers to meet specific rules and requirements based on the type of services they intend to offer. It is essential to confirm these requirements before submitting enrollment information. Providers should:

Consult the Eligible Providers section on the MHCP website to identify licensure and certification requirements for their provider type.
Review the Provider Screening Requirements page in the MHCP Provider Manual for comprehensive screening criteria.

Obtaining a Provider Identification Number: NPI or UMPI

A crucial part of the enrollment process is securing the correct provider identification number. For most providers, this is a National Provider Identifier (NPI), a unique identifier required for healthcare claims processing. Eligible providers must obtain their NPI from the National Plan and Provider Enumeration System (NPPES) before enrolling with MHCP.

However, certain provider types who may not meet the federal definition of a healthcare provider under HIPAA may not be eligible for an NPI. These include:

Home and community-based services providers
Personal care provider organizations providers
Day training and habilitation providers
And others as listed in the original document.

For these providers, MHCP will assign a Unique Minnesota Provider Identifier (UMPI) upon application processing if they do not already possess an NPI. Whether an NPI or UMPI, this identifier is mandatory for all fee-for-service claims submitted to MHCP to ensure accurate payment.

Submitting Enrollment Documentation

Providers can submit their enrollment documents to MHCP through two primary methods:

MPSE Portal: The most efficient method is online enrollment via the Minnesota Provider Screening and Enrollment (MPSE) portal. The portal offers built-in guidance, error detection, and application status tracking.
Fax: Alternatively, providers can complete the required forms and fax them to MHCP’s Provider Eligibility and Compliance division.

Specific forms and requirements are detailed in the manual section relevant to the services being provided, accessible via the Eligible Providers section of the MHCP website. It’s important to note that MHCP does not accept enrollment documents via email.

Payment Methods: EFT is the Preferred Choice

Addressing the key question: Is Institutional Care Program Paid By Check Or Eft? MHCP primarily utilizes Electronic Funds Transfer (EFT), also known as direct deposit, for payments to fee-for-service providers, including those offering institutional care. While paper checks might be an option in limited circumstances, EFT is strongly recommended and is the most efficient and secure payment method.

MHCP encourages all fee-for-service providers to enroll in EFT for several compelling reasons:

Speed: EFT payments are significantly faster than traditional checks. Providers gain quicker access to funds, eliminating mail delays and bank deposit trips.
Security: EFT reduces the risk of lost, stolen, or misdirected checks, enhancing payment security.
Efficiency: EFT streamlines cash flow management and reduces paperwork, simplifying administrative processes.

To receive EFT payments, providers must have an active 10-digit supplier ID and a 3-digit supplier location code from Minnesota Management and Budget (MMB). The process to establish a supplier ID involves:

Registering as a “New Supplier” on the Minnesota Supplier Portal.
Adding or updating banking information via the Supplier Portal or submitting the MMB EFT Bank Change Request (PDF).
Allowing 10 business days for the supplier ID to become active after banking information is entered.
Entering the EFT supplier ID and location code in the MPSE portal or submitting the EFT Supplier ID Notification (DHS-3725) (PDF) form.

For providers participating in Managed Care Organization (MCO) networks, it’s important to note that while the enrollment process with MHCP is necessary, payment arrangements are typically handled directly through the contracted MCO. The EFT enrollment through MHCP is primarily for fee-for-service payments.

Enrollment Approvals and Timelines

MHCP aims to process complete enrollment requests efficiently. For Minnesota-based providers, retroactive approvals may be possible, with the effective date determined by factors like the provider’s requested date, the date of application receipt, or the member’s MHCP eligibility date.

Processing timelines for both new enrollments and changes to existing enrollments are generally within 30 days of receiving a complete request. Incomplete requests will result in a request for more information (RFMI), and providers are given specific timeframes to respond and provide the necessary details.

Staying Updated and Managing Enrollment

Providers are responsible for maintaining up-to-date enrollment information. Changes can be efficiently reported through the MPSE portal. MHCP also offers quarterly webinars on managing enrollment changes via the MPSE portal.

Forms for reporting changes via fax are also available, such as:

Conclusion: Embrace EFT for Efficient MHCP Payments

In conclusion, while the possibility of receiving payments by check might exist in specific scenarios, Electronic Funds Transfer (EFT) is the standard and strongly preferred payment method for institutional care programs and other healthcare services within Minnesota Health Care Programs. EFT offers significant advantages in terms of speed, security, and efficiency, benefiting both providers and MHCP. By enrolling in EFT and utilizing the MPSE portal for enrollment and management, providers can ensure a streamlined and reliable payment process, allowing them to focus on delivering quality care to MHCP members. For any further questions or assistance, providers are encouraged to consult the MHCP provider manual and utilize the resources available on the MHCP website.