Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting August 1, 2021, UCare is updating prior authorization criteria for six drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
See the June 11 Provider Bulletin for details.
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June 2021 Health Lines
Learn about UCare's Updated Provider Manual, Innovative UCare GEDWorks Program Expands Statewide, Minnesota Department of Health (MDH) Roster ID Required for All Interpreter Claim Submissions, Dental Access for Members, Creating Access to Healthy and Affordable Food for UCare Families, Documentation Improvement: Focus on Cerebrovascular Accidents/Stroke, Ineligible Provider List Updated 6-2-21, Upcoming Holidays and more.
Read the June 2021 Health Lines.
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2021 Update to UCare's Provider Manual
UCare’s 2021 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.
Go to the Provider Manual.
2021 Summer Camps Available for Young UCare Members
Providers who see young UCare members in Prepaid Medical Assistance Program (PMAP) and MinnesotaCare will have several summer camp opportunities they can share with the patients. UCare is teaming up with Wilderness Inquiry and One Heartland to offer the camps to eligible members at no cost. Additionally, the American Diabetes Association (ADA) offers a virtual summer camp at no cost.
See the April 29 bulletin for details.
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Authorization and Notification Requirements Update: Outpatient Substance Use Disorder Services
Effective immediately, UCare will return to approving notifications for up to six months of services for outpatient subsstance use disorder (SUD) services for individual/group (H2035 or H2035HQ).
See the April 26 bulletin for details.
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Reminder: UCare Medicare Part D Vaccine Information
Starting Jan. 1, 2021, UCare began denying claims for providers administering Part D vaccines in their clinics. Provider will need to bill both the vaccine and administration through the member’s Part D benefit.
See the Feb. 4 bulletin for details.
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Critical Business Reminders
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.
See the August 2020 Bulletin.
Changes to the Payment and Remittance Selection Process
Effective immediately, UCare is changing the process to request updates to the provider’s payment and remittance selections.
Read the Dec. 18 bulletin for additional details on the changes.
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