March 2019 edition of the Health Lines Provider Newsletter
In this edition, read the upated alert for the Online Submission of the Claims Reconsideration Request Form Delay, 2019 UCare Provider Manual update, Provider FAQs – New UCare Claims System, Healthy Saving Discount program, and documentation for Deep Vein Thrombosis (DVT).
See the March Health Lines
UCare Online Submission of Claims Reconsideration Requests Delayed
UCare’s launch of the online submission of the Provider Claim Reconsideration Request Form has been delayed. At this time, Providers should continue to use the current form.
Read the March 4 Provider Bulletin
UCare Provider Manual 2019 Update
The Provider Manual has been updated to reflect current business practices. UCare has prepared a Provider Bulletin outlining the key updates.
Read the bulletin.
See the Provider Manual
.
Provider FAQs – New UCare Claims System
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.
Click here to see the Feb. 17 FAQs
Updates on 2019 IFP Claim Payments & Electronic Transactions
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.
Updates on 2019 Claim Rejection Edits
UCare has developed a bulletin regarding issues that may cause claim rejection edits.
See the
full bulletin.
Updates on Member Eligibility Services for 2019 Individual & Family Plan Members
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
.
Additional Enrollment Opportunities for Medicare Members
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:
- Special Enrollment Period (SEP) - Dec. 8, 2018 to Feb. 28, 2019
- Medicare Advantage Open Enrollment Period - Jan. 1, 2019 to March 31, 2019
Code and Editing Updates Reminder
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.
See the full Provider Bulletin
Jan. 1, 2019, Changes for Personal Care Assistance & Home Care Nursing Providers Serving Members Under Age 65
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.
Read the full bulletin here.
UCare Choices Claims Editing Changes for 2019
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).
See the full Provider Bulletin.
UCare 2019 Authorization Grids
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.
Go to the Web Page
UCare to Suspend Authorizations in 2019 For UCare Choices Plans
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).
See the full Provider Bulletin.
UCare Choices Plans Claims Submission Changes for 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).
See full Provider Bulletin
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