UCare to Introduce Online Submission of Provider Claims Reconsideration Form
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 Closed for Holiday
UCare and the Provider Assistance Center (PAC) will be closed on Monday, Jan. 21 for Martin Luther King Jr. Day. If you need assistance during that that time, please login to the Provider Portal to verify eligibility, check claim status or send a message to PAC.
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
.
Atypical Providers Only: NPI Edit Error Impacting Atypical Providers with Availity
UCare has been alerted that there is an issue with Availity – atypical transportation providers are receiving “...MISSING BILLING PROVIDER NPI” rejection in error for billing without an NPI. Availity has informed us that they have classified this issue as a high priority. We will update this notice as we learn more. Please direct any questions about this issue to Availity. We apologize for the inconvenience.
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
January 2019 edition of the health lines Provider Newsletter
In this edition, read about changes for PCA and HCN services billed to members under age 65, new product names, 2019 Opioid Edits, enhanced prior authorization DME/Supply form, and documentation improvement for MI.
See the January health lines
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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