DHS-8174A-ENG   1-25 (1.2.3)

Health Care Consumer Support Document Portal for Partners and Providers

Welcome to the Health Care Consumer Support Document Portal for Partners and Providers!

This portal can be used by partners and providers to submit health care information such as applications, renewals, health plan enrollment forms, verifications, proofs, and other documents to Health Care Consumer Support.

Do not use the portal to submit documents to a county or tribal agency. View Agency Addresses (DHS-5207) to find the correct contact information.

How do I submit documents?

Partners and providers must select the appropriate option in order to submit documents correctly.

  • Partners
    • Who should use this option? Counties, tribes, navigators, resettlement agencies, Department of Corrections, and other partners.
    • What should they submit? MinnesotaCare and certain public health care applications, renewals, and other related documents, and health plan forms for MinnesotaCare, MSHO, and SNBC for which DHS or MinnesotaCare operations is responsible for processing.
  • Provider
    • Who should use this option? Minnesota Family Planning Program (MFPP) and Hospital Presumptive Eligibility (HPE) providers
    • What should they submit? HPE and MFPP documents.

Select Partner if you are submitting health care applications, renewals, health plan forms, and other documents.

Select Provider if you are submitting documents for only MFPP or HPE.

Instructions

What documents can I submit?

Use this portal to submit documents to Health Care Consumer Support for Minnesota Health Care Programs (MHCP) or health plan enrollment.

The HCCS document portal accepts forms for MinnesotaCare, need to renew forms for households with both MinnesotaCare and Medical Assistance members, and certain other public health care program forms that are processed by HCCS. Direct households with both MA and MinnesotaCare (mixed households) to the appropriate county or tribe.

You can use this form to submit:

  • Health care applications
  • Health care renewal forms
  • Documents to provide proof and verification
  • Documents to report changes
  • Health plan enrollment forms

Use this portal to submit documents to Health Care Consumer Support for Minnesota Family Planning Program (MFPP) eligibility determinations.

You can use this form to submit:

Use this portal to submit documents to Health Care Consumer Support for Hospital Presumptive Eligibility (HPE) eligibility determinations.

You can use this form to submit:

If you have questions or need help

See the Frequently Asked Questions (FAQ) for Partners and Providers.

If you need additional help, contact Health Care Consumer Support Monday through Friday from 8:00 am to 5:00 pm.

  • Minnesota Care: 651‑297‑3862 or 800‑657‑3672.
  • MA for Inmates, Red Lake Nation, and Deferred Action for Childhood Arrivals (DACA): 651‑431‑3480 or 888‑702‑9968.
  • Refugee, Secured Services, Center for Victims of Torture: 651‑478‑8380.

See the Frequently Asked Questions (FAQ) for Partners and Providers.

If you need additional help, contact Health Care Consumer Support Monday through Friday from 8:00 am - 5:00 pm: 651‑431‑3480 or 888‑702‑9968, option 3.

See the Frequently Asked Questions (FAQ) for Partners and Providers.

If you need additional help, contact Health Care Consumer Support Monday through Friday from 8:00 am - 5:00 pm: 651‑431‑3480 or 888‑702‑9968, option 1.

Tell us about the person for whom you are submitting documents

Enter the person's legal name as it appears on their case.

Case numbers are usually located on the upper left-hand or right-hand corner of notices, but they may be located elsewhere. Case numbers are generally 8 (characters) digits or letters. If your case number is less than 8 characters, enter zeros at the beginning to make up the difference.

MFPP case numbers start with an F and will have 7 digits following. MinnesotaCare and Medical Assistance cases generally start wtih a number and have a total of 8 digits. If the MinnesotaCare or MA case number is less than 8 digits, add zeros in front to make up the difference.

Attach documents

  • Attach documents in the correct category for the type of document.
  • Acceptable file types are PDF, TIF, JPG, PNG, Word, and Text.
  • iPhone or iPad photos in the default file type (HEIC or HEIF) are not accepted. If using an iPhone or iPad to take photos, you will need to convert them to an acceptable file type such as those listed above.
  • It is recommended that you submit applications, renewals, or taxes as a PDF due to file size limitations.
  • You can attach:
    • Either a single application or a single renewal.
    • Multiple verifications, proofs, and other documents.
    • A single health plan enrollment form.
  • There are file size limits and limits on the number of attachments for each document category. You must stay within the file size limits and the maximum number of allowed attachments per category, or you will receive a message that your documents did not attach.

Select the appropriate category from the list below and upload each document type separately using the specified document types.

  • Attach documents in the correct category for the type of document.
  • Acceptable file types are PDF, TIF, JPG, PNG, Word, and Text.
  • iPhone or iPad photos in the default file type (HEIC or HEIF) are not accepted. If using an iPhone or iPad to take photos, you will need to convert them to an acceptable file type such as those listed above.
  • It is recommended that you submit applications, renewals, or taxes as a PDF due to file size limitations.
  • You can attach multiple verifications, proofs, and other documents.
  • There are file size limits and limits on the number of attachments for each document category. You must stay within the file size limitations and the maximum number of allowed attachments per category or you will receive a message that your documents did not attach.

Attach each document to the appropriate type.

You can attach one application along with other related documents and a health plan enrollment form. You can attach a maximum of 5 application-related files.

Standard applications are the:

  • MNsure Application for Health Coverage and Help Paying Costs (DHS-6696)
  • MHCP Application for Certain Populations (DHS-3876)

Submit a MNsure Application for Health Coverage and Help Paying Costs (DHS-6696). Direct other applications for Centers for Victims of Torture to the appropriate county or tribe.

Submit a MNsure Application for Health Coverage and Help Paying Costs (DHS-6696).

Submit a MNsure Application for Health Coverage and Help Paying Costs (DHS-6696); a MHCP Application for Certain Populations (DHS-3876); or a MA Inpatient Hospital Coverage for Incarcerated People (DHS 6696G).

Submit a MNsure Application for Health Coverage and Help Paying Costs (DHS-6696) or MHCP Application for Certain Populations (DHS-3876).

    You can attach one renewal along with other related documents and a health plan enrollment. You can attach a maximum of 5 renewal-related files.

    Submit Need to Renew forms for MinnesotaCare and households with both MA and MinnesotaCare (mixed). Direct Need to Renew forms with Medical Assistance only households to the appropriate county or tribe. Direct households with both MA and MinnesotaCare (mixed) households to the appropriate county or tribe.

    Submit Auto Renew forms for MinnesotaCare. Direct the Auto Renew for Medical Assistance only to the appropriate county or tribe. Direct households with both MA and MinnesotaCare (mixed households) to the appropriate county or tribe.

    Submit renewals that have both the Department of Human Services and MNsure logos in the top right corner.

    Submit Need to Renew forms for MinnesotaCare.

    Submit Auto Renew or Need to Renew forms for MinnesotaCare and Medical Assistance.

      You can submit MFPP Presumptive Eligibility forms and ongoing applications along with supporting documents at the same time. You can attach a maximum of 5 files.

      Submit pages 1, 2, and 7 of the Minnesota Family Planning Program Application and Renewal (DHS-4740). Be sure the document is signed.

        Submit the Minnesota Family Planning Program Application and Renewal (DHS-4740). Be sure the application is signed.

          Submit the Minnesota Family Planning Program Application and Renewal (DHS-4740). Be sure the renewal is signed.

            Submit the Hospital Presumptive Eligibility (HPE) Application (DHS-3881). You can attach a maximum of 5 presumptive eligibility files.

              Submit the MNsure Application for Health Coverage and Help Paying Costs (DHS-6696). You can attach a maximum of 5 application files.

                You can submit multiple proofs, verifications, and other documents.

                Authorized representative proofs and verifications may be the "Giving Permission for Someone to Act on My Behalf" (DHS-3437); Appendix C of the DHS-6696; Appendix B of the DHS-3876; or other legal documents. You can attach a maximum of 2 Authorized Representative files.

                  Citizenship, identity, immigration, and tribal membership proof and verification may be a birth certificate, passport, front and back of immigration cards, other immigration papers, tribal membership cards, and other related documents. You can attach a maximum of 6 citizenship, identity, immigration, or tribal membership files.

                    Consent or authorization for the release of information may be the General Consent/Authorization for Release of Information (DHS-3549). You can attach a maximum of 2 authorization for release of information files.

                      Income and projected annual income proofs and verifications may be complete Federal tax returns (W2s, schedules, and forms), paystubs, proof of alimony, copies of business financial records, employer statements, and other income documents. You can attach a maximum of 5 income files.

                        Other health insurance proofs and verifications may be the front and back of a health plan card, Medicare card, Tricare card, COBRA documents, Appendix A: Health Coverage from Jobs (DHS-6696D), and other insurance documents. You can attach a maximum of 3 other health insurance files.

                          Other proofs, verifications, and documents may be a signature page, change report form, address change documents, information about other household members, and other requested documents. You can attach a maximum of 3 other proofs, verifications, or documents files.

                            Authorized representative proofs and verifications may be the MFPP – Giving Permission for Someone to Act on My Behalf (DHS‑3437A); Attachment C of DHS‑4740; or other legal documents. You can attach a maximum of 2 Authorized Representative files.

                              Citizenship, identity, immigration, and tribal membership proofs and verifications may be a birth certificate, passport, front and back of immigration cards, other immigration papers, tribal membership cards, and other related documents. You can attach a maximum of 6 citizenship, identity, immigration, or tribal membership files.

                                Consent or authorization for the release of information may be the Authorization to Request Birth Records (DHS-4841) or General Consent/Authorization for Release of Information (DHS-3549). You can attach a maximum of 2 authorization for release of information files.

                                  Income proofs and verifications may be complete Federal tax returns (W2s, schedules, and forms), paystubs, proof of alimony, copies of business financial records, employer statements, and other income documents. You can attach a maximum of 5 income files.

                                    Other health insurance proofs and verifications may be the front and back of a health plan card, Medicare card, Tricare card, COBRA documents, Appendix A: Health Coverage from Jobs (DHS-6696D), and other insurance documents. You can attach a maximum of 3 health insurance files.

                                      Other proofs, verifications, and documents may be a signature page, change report form, address change documents, information about other household members, and other requested documents. You can attach a maximum of 3 other proofs, verifications, or documents files.

                                        You can only submit one health plan enrollment form. You can attach a maximum of 3 health plan enrollment files.

                                        A Health Plan Enrollment Form could be an enrollment notice for MinnesotaCare or Minnesota Senior Care +.

                                          Annual Health Plan Selection enrollment notice for MinnesotaCare or Minnesota Senior Care +.

                                            An MSHO enrollment form could be an enrollment notice or a Health Plan Enrollment for People 65 and Older. To disenroll, you can also submit a signed, written statement that includes your name, date of birth, and case number.

                                              A Special Needs BasicCare Choice form.

                                                To disenroll or opt out of SNBC, you can submit a Special Needs BasicCare Choice form or submit a signed, written statement that includes your name, date of birth, and case number.

                                                  Person who is submitting records

                                                  Your submission is not complete until you receive the message that your submission was successful. Your total submission size (all attachments combined) cannot be larger than 500 MB. Attempts to make a submission larger than 500 MB will not be successful. You will need to resubmit the document(s) using multiple submissions of smaller file sizes.