Starting July 1, 2021, UCare is updating prior authorization criteria for 19 drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
See the May 11 Provider Bulletin for details.
Learn about UCare's Provider Manual Q2 Update, New Coverage Policies Added, Policies & Resources Page Houses Many Tools for Providers, Important Reminders for Mental Health and Substance Use Disorder Services Authorizations, COVID-19 Information for Providers, Continuous Glucose Monitor Reviews Regulated by Local Coverage Determinations, Model of Care Training, Accurate Member Information is Key to Smooth Claim Submissions, Documentation Improvement: Diabetes, Cultural and Linguistic Competence, Keeping UCare Members Active, Upcoming Holidays and more.
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.
Learn about COVID-19 Information for Providers, UCare and Minnesota Medical Association Collaborate on Health and Racial Equity, Ineligible Provider List Updated, COVID-19 Vaccine Outreach, Documentation Improvement: Parkinson's Disease, 2021 Summer Camps for Young UCare Members and more.
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.
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.
Protest activity in and around the Twin Cities may limit access to certain pharmacies. To assist providers, UCare has created a list of frequently asked questions about the situation.
Read the April 12 Pharmacy bulletin for details.
The Food and Drug Administration has authorized Emergency Use Authorization and approved multiple monoclonal antibody therapies for treatment of mild-to-moderate COVID-19 in adults and pediatric patients who are at high risk for progressing to severe COVID-19 and/or hospitalization.
See the April 6, 2021 Provider Bulletin for details.
Medicare claims submitted with billing or rendering provider specialty/taxonomy not included on the Medicare/Supplier crosswalk will deny for invalid provider taxonomy.
See the March 31, 2021 Provider Bulletin for details.
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.
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.
New codes have been identified for 2021 and will be accepted into the UCare system as of the effective dates but are subject to the editing update and implementation dates.
See the Dec. 29 bulletin for details.
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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