Health Care Case Coordinator Enrollment Criteria and Forms

Revised: January 31, 2024

A health care case coordinator may be a county case manager subcontracting with a managed care organization (MCO) or be employed by an MCO to enroll as a health care case coordinator with Minnesota Health Care Programs (MHCP). Health care coordinators (including county staff on behalf of MCOs) complete and enter long-term care consultation (LTCC) screening documents on behalf of MCOs.

County staff who are contracted with health plans to provide care coordination activities for a person on a waiver enrolled in managed care, as well as care coordinators employed by health plans, must be identified on the screening documents and service agreements as a care coordinator (provider type 27). This will be in addition to their enrollment as a county or tribal case manager (provider type 23) in some cases. Only one care coordinator enrollment record is needed, even if the care coordinator is contracted with more than one health plan.

How to Enroll

Health care case coordinators who want to enroll or reenroll with MHCP can do so in one of the following two ways.

Online MPSE Portal

Register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete your enrollment online using the MPSE portal.

or

Submit Forms via Fax

Complete the Health Care Case Coordinator – Provider Enrollment Application (DHS-4474) (PDF) to enroll as a health care coordinator and fax it to MHCP Provider Eligibility and Compliance at 651-431-7462.

Review and keep a copy of the MHCP Data Privacy Notice (DHS-6287) (PDF).

We process forms in order of the date received. Whether enrolling using the MPSE portal or by fax, allow 30 days for processing. If we need more information to complete your enrollment, we will send a request for more information letter via the U.S. Postal Service (or your MN–ITS mailbox, if you have an account) explaining what you need to do to complete your enrollment.

Reporting Changes

Report any changes made on a provider record to MHCP Provider Eligibility and Compliance. Refer to the Changes to Enrollment in the Enroll with MHCP section of the MHCP Provider Manual for details.

Legal References

Minnesota Statutes, 148B.5301 (Licensed Professional Clinical Counselor)