Pre-authorized medical services

Medical services (including treatment)


When you are enrolled in a health plan you must receive all your medical services through that health plan's providers or have a referral from the health plan to go outside of the network for medical services. Most billing problems are the result of not following this rule. If you have billing issues or problems getting services covered, please call your Member Services phone number on the back of your Health Plan card. If you are Fee for Service MA, commonly referred to as straight MA, call the Member Services telephone number on the back of your MN Healthcare Card. 
 

Troubleshooting


If insurance denies coverage for a certain medical service, your first step is to contact your member services on the back of the health plan card. If this does not generate satisfactory results, the advocate will direct you to the Minnesota ombudsman's office 800.657.3729, and you may file an appeal.