UCare is implementing a new claims system platform over the next few years. To assist providers, we have prepared a list of frequently asked questions regarding the transition.
As UCare processes claims in the new claims system platform for members in Individual & Family Plans, providers will notice differences in the EOPs, ACH Payments, demographic updates and more.
See the full bulletin for additional details.
In this edition, read about the Enhanced Prior Authorization DME/Supply Form available Feb. 2019 to submit claims electronically, March 4, 2019, Online Submission of Claim Reconsideration will be available. April 1, 2019, UCare will no longer accept paper Claim Reconsideration Forms, Also in this meditation, case management (ICM) program, Medication Assisted Treatment (MAT) Protocol, and clinical documentation of obesity.
On March 4, 2019, UCare will introduce online submission of the Provider Claims Reconsideration Form. We will phase out acceptance of the current form through traditional mail and secure fax effective April 1, 2019.
See the full bulletin .
UCare has developed a bulletin regarding issues that may cause claim rejection edits.
See the full bulletin.
UCare has identified some additional work required to accurately report member eligibility status for 2019 Individual & Family Plan members in our Interactive Voice Response and our 270/271 HIPAA Transaction. We anticipate 2019 IFP member eligibility should be available in our IVR system by Jan. 18, 2019, and in the 270/271 HIPAA transaction by Jan. 31, 2019. We apologize for this inconvenience. Providers can obtain updated member eligibility status in UCare’s Provider Portal and by contacting the Provider Assistance Center. Member eligibility status is available for all other UCare health plans using the IVR and the 270/271 HIPAA Transaction.
See the full bulletin .
Medicare-eligible individuals have multiple opportunities to enroll in the most appropriate plan to meet their needs.
We’ve prepared a Provider Bulletin to help explain the following enrollment periods:
UCare uses multiple automated claims editing and pricing applications to ensure consistent and accurate processing of claims. Please allow appropriate time for the updates to be put into production.
Changes have been announced for Personal Care Assistance (PCA) and Home Care Nursing (HCN) providers who provide services to Minnesota Health Care Program recipients under age 65 who are enrolled with UCare.
On Jan. 1, 2019, UCare will make changes that affect claims edits for only UCare Choices and Fairview UCare Choices plans (to be renamed UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview in 2019).
UCare's 2019 authorization and notification requirements are now available on our website at ucare.org/providers, under the Eligibility & Authorization section: State and Public programs, UCare Medicare Pans, EssentiaCare, Behavioral Health and Pharmacy.
During 2019, UCare will temporarily suspend the requirement for prior authorizations for services delivered to members with UCare Choices and Fairview UCare Choices (renamed as UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview in 2019).
Effective January 1, 2019, UCare will make changes that affect claims submission for only UCare Choices and Fairview UCare Choices plans (to be renamed UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview on January 1, 2019).
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Claims Attachments: 612-884-2261
Claims Adjustments: 612-884-2186
Prior Authorization Requests:
612-884-2499 or 1-866-610-7215
Rate updates (CAH, RHC, FQHC): RateLetters@UCare.org