UCare is committed to protect our members and the community from the spread of coronavirus (COVID-19). The COVID-19 situation is changing quickly, and we are monitoring changes closely. To assist our provider partners in navigating this changing situation, UCare has created a Frequently Asked Questions page.
UCare’s 2020 Provider Manual contains critical information that providers need to know to effectively work with UCare and our members. It is important that providers reference the online manual regularly for up-to-date content. The Provider Manual has been updated to reflect current business practices. UCare has prepared a Provider Bulletin outlining the key updates.
UCare informs providers of critical business reminders for the Credentialing and Recredentialing Process, Pharmacy, Complex Case Management Process, Utilization Management Information, Member Rights and Responsibilities, Shared Decision Making and Clinical Practice Guidelines.
New codes that have been identified for 2020 will be accepted into the UCare system as of the effective dates but are subject to the editing update and implementation dates. Please allow time for the updates to be put into production to avoid resubmissions/ adjustments/incorrect editing of the claims.
Effective Jan. 1, 2020, UCare will make changes that affect claims submission and edits for all UCare Medicare and State Public Program plans. UCare will be adding a higher SNIP level to inbound claims submission for these plans in 2020.
UCare is continuing to implement our new claims system. Effecitve Jan. 1, 2020, UCare will make changes that affect claims submissions for UCare Medicare Plans that include a new Payor ID for 2020 claims and new Member ID and format.
Beginning Jan. 1, 2020, Care Continuum, a subsidiary of Express Scripts, will be performing Medical Benefit Drug Prior Authorization reviews for all of UCare’s lines of business. Learn about how to initiate prior authorization requests with Care Continuum, which medical drugs requiring prior authorization and additional changes for 2020 and Biosimilar step therapy for medical drugs in 2020.
On Jan. 1, 2020, UCare changed the Payor ID to 55413 for UCare Medicare Plans, EssentiaCare and UCare Medicare with M Health Fairview & North Memorial claims submissions for 2020 dates of service. Please be aware that 2019 claims still need to be submitted under the old Payor ID 52629.
UCare’s Pharmacy Department has been closely monitoring the COVID-19 developments and taking appropriate action to ensure our members have access to medication.
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