On July 10 and 11, 2019, the UCare Provider Claim Reconsideration Form was not functioning properly and, in some cases, did not submit data. The issue has been corrected. If you submitted a form on these days, please check the Impacted Submissions List to see if your confirmation number is listed. If so, you will need to resubmit your request. If you have additional questions, contact the Provider Assistance Center. We apologize for the inconvenience.
Some providers have received an inaccurate A3 Reject, 99 Pretreatment Review message for certain Individual and Family Plans claims. We are working to resolve this issue. In most cases, the claims have not rejected and are being processed. Providers may check the provider portal or contact the Provider Assistance Center (612-676-3300) to verify that UCare has received the claim(s) and to check the status of the claim(s). We apologize for any inconvenience.
On Jan. 1, 2019, as part of the Substance Use Disorder Reform, the Minnesota Department of Human Services (DHS) advised on the use of the HF modifier with code H0001 to distinguish between a Rule 25 Assessment and a Comprehensive Assessment. UCare has aligned its claim system with the DHS reform.
Providers who have submitted a Medical and Behavioral Health prior authorization between January and March will be sent a survey about their experience via email or fax. We look forward to receiving your feedback on this important service. As a thank you, we will award two respondents with a free lunch (value up to $100) for completing the survey.
UCare recently updated its Utilization Review Criteria. A memo was developed to outline the changes to Behavioral Health and Medical Care criteria.
Starting July 1, 2019, UCare will adopt the Department of Human Services’ (DHS) Preferred Drug List (PDL) for members in Prepaid Medical Assistance Program, MinnesotaCare, Minnesota Senior Care Plus and UCare Connect.
Please see the June 4 Provider Bulletin
On May 20, 2019, UCare will introduce online submission of the Provider Claim Reconsideration Form. Online submission offers many benefits to providers, including notification of request receipt, reduction in clerical paperwork and staff-time to submit, follow-up and track, lower paper and postage costs, and quicker overall processing time.
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.
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.
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