CoOportunity Health has contracted with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services.
Our goal is to cover the use of new technologies and new uses for established technologies when they’ve been scientifi cally demonstrated to be safe, effective, and medically necessary for the condition being treated. To help us decide whether to begin covering new therapies and procedures, we review the recommendations of the HealthPartners Medical Directors Committee. This physician led group, which includes CoOportunity Health’s Medical Director, follows a formal process to analyze information from such varied sources as peer-reviewed medical articles, formal technology assessments, government regulatory agencies and expert opinions from practicing physicians. CoOportunity Health generally extends health plan coverage to all procedures, drugs, devices and technologies that have been demonstrated to be safe, effective, and medically necessary unless an equally safe, effective, less costly alternative exists. New technologies that do not meet these standards are considered experimental/investigative and are generally not covered. In some cases, coverage may be limited due to contract exclusions.