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January 2026 Top of Mind

Medica providers: Take 5 minutes to check

All providers must be actively enrolled as Medicaid providers with the State of Minnesota and appear in the Minnesota Health Care Programs (MHCP) enrollment system before providing services to Medicaid members.

Providers must be:

  • Actively enrolled with MHCP
  • Listed in the MHCP system as eligible and compliant—this is managed through the Minnesota Provider Screening and Enrollment (MPSE) portal
  • Not excluded from participation (based on federal/state exclusion lists)
  • Compliant with ownership disclosure requirements, which includes submitting a Disclosure of Ownership every 5 years or when ownership changes occur

How can I verify my MN Medicaid network status?
You can verify your Medicaid network status by:

  • Checking your provider profile by logging into the Provider Express secure portal
  • Calling Provider Services at 1-877-614-0484 (facilities must use this option)
  • Contacting your Provider Relations Advocate

Contracting may need to occur before a provider is eligible to care for Medicaid network members. Your Provider Relations Advocate can determine if this is necessary. To ensure Medicaid networks are added to your provider profile, update your National Provider Identifier (NPI) in the MHCP enrollment system.

Who is affected?
All provider types must be enrolled with MN Medicaid, including:

  • Individual providers
  • Provider groups
  • Facilities

How do I register with MHCP?
You can register with your National Provider Identification (NPI) with MN Medicaid program in the screening and enrollment portal found on the MN registration and access page.

What happens if I don’t enroll?
Optum cannot assign effective dates to provider profiles until this state registration is complete and verified through the MHCP system.

If a Medicaid ID is added using an Optum process ― including the New Provider Request Form, Clinician Tax ID add/update form, or the roster process ― but it cannot be reconciled with the state system, Medicaid networks will not be added in our system at that time.

Can I get a retroactive enrollment? Yes. Minnesota providers may be approved retroactively. If the provider meets the enrollment requirements for the enrollment type, the enrollment application will be approved with an effective date using one of the following:

  • The effective date the provider requests in MPSE or on the enrollment application
  • On the first day of the month in which we receive the enrollment request
  • For up to 90 days before the effective date of the provider’s Medicare certification
  • The retroactive date the member is confirmed to be eligible for MHCP
  • The date the provider is confirmed to meet all MHCP provider requirements

If the state assigns a retroactive effective date, this does not guarantee Optum will match the new effective date for claims and/or services previously rendered.

Have questions about the process?
Please contact your Provider Relations Advocate or call Provider Services at 1-877-614-0484, Monday–Friday, 7 a.m.–7 p.m. CT.

 


 

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