UCare has updated the following chapters of the Provider Manual: Working with UCare, Sales & Marketing by Providers, Provider Credentialing, Behavioral Health and Nursing Facility Services. Specific updates are called out in the Appendix.
UCare held its 11th annual "A Salute to Excellence!" event Thursday, Sept. 26, to honor 22 Minnesota clinics and care systems with top results in 2018 Healthcare Effectiveness Data and Information Set (HEDIS) measures
The October Health Lines informed providers that effective Nov. 1, 2019, UCare will require the services previously submitted with HCPCS S9484 to be submitted using HCPCS code H2011. There was an error in the billing grid that was included in the article. Community intervention services should still be submitted using HCPCS code 90882.
We apologize for any inconvenience this error may have caused.
UCare is continuing to implement our new claims syste. 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.
During 2019, UCare will temporarily suspend the requirement for prior authorizations for services delivered to members with UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview.
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.
UCare has updated its authorization requirements for CTSS thresholds and SUD inpatient admission and residential treatment services to align with DHS changes.
Effective Jan. 1, 2020, the amount of the tax imposed on health care providers under Minn. Stat. § 295.52 (known as the “MinnesotaCare Tax”) is changing from 2% to 1.8% of gross revenues. As a result, the portion of provider reimbursement that represents payment by UCare for providers’ MinnesotaCare Tax expense will be adjusted accordingly, as applicable, effective for dates of service beginning Jan. 1, 2020.
Effective Jan. 1, 2020, providers billing Medicare Certified Home Health Care or End-Stage Renal Disease (ESRD) services to UCare must submit claims in accordance with Centers for Medicare & Medicaid Services (CMS) billing guidelines, including all required claim elements.
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.
UCare's 2020 medical services and behavioral health authorization and notification requirements are now available on ucare.org/providers, under the Eligibility & Authorization section, including State and Public Programs, UCare Medicare Plans and UCare Medicare Plans with M Health Fairview & North Memorial, EssentiaCare and UCare Individual & Family Plan and UCare Individual & Family Plan and M Health Fairview.
Receive our monthly newsletter and bulletins with timely updates from UCare right to your inbox.SIGN UP
We’ll help you determine if you are eligible to join our network
and make sure you have everything you need to submit your application.
Find Care Coordination resources for all UCare products.
You can also find the training schedule and get contact information.
Provider Assistance Center:
612-676-3300 or 1-888-531-1493
Hours: 8 a.m. to 5 p.m., Monday through Friday
Register for a Provider Account to access member eligibility
and claim status information.
Need help registering?
Contact your provider administrator to create
and modify user accounts
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