Care Management

Contacts

 

 

Care Coordination Contact List  
Revised 1.22.2020

UCare Clinical Liaisons

 

 

UCare Clinical Phone List  
Revised 5.14.19

 

 

Newsletters & Alerts

 

February 2020 issue of the Clinical Services Program Update 

Read about behavioral health department reminders like the triage line, and learn more about pain management, opioid guide, tobacco cessation outreach, quit for life, preventing falls, SilverSneakers, 2020 medical drug prior authorizations, PA, Medicare Experience survey, Elderly Waiver services, DHS webinar on Institutional Levels of Care and the 2020 Training schedule.

February 2020 Care Coordination News

 


 

Alert - CDCS Rate Change Process

DHS implemented a rate increase for CDCS for Elderly Waiver members effective January 1, 2020. UCare will be sending out a list of members who have been identified as receiving CDCS to leadership within your agency.

See the CDCS bulletin.

 

 

 

DHS Bulletin #19-25-01: Service rate changes for long-term services/supports: effective July 1st, 2019

Percent rate increase for long-term servce inckude home-delivered meals (S5170) for Alternative Care (AC), Elderly Waiver (EW) and Essential Community Supports (ECS); Personal Care Attendant (PCA), Consumer Directed Community Supports (CDCS) and Consumer Support Grant (CSG). UCare will be identifying members who are receiving CDCS services and reaching out individually to the affected delegates.

Read the June 26 Alert.

 

 

Updated Requirements Grids -  Effective Jan.1, 2020

UCare has updated the UCare Connect, UCare Connect Expansion, and UCare Connect + Medicare, with the UCare MSHO/MSC + Community and Institutional requirement grids. During the month of December, we encourage you to review the changes outlined in the grids. All changes on the grids are highlighted in yellow. 

 

 

 

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2020 UCare Training Schedule

 

UCare Product

Meeting Type

Date & Time
UCare Connect and UCare Connect + Medicare Bi-Annual Meetings: Metro Delegates

May 20, 9 a.m. to 12 p.m.

Nov. 18, 9 a.m. to 12 p.m.
UCare Connect and UCare Connect + Medicare Bi-Annual Meeting recorded WebEx will be posted on the UCare website by

May 27, 2020

Nov. 25, 2020
UCare's MSHO & MSC+ Bi-Annual Meetings: Metro Delegates

March 18, 9 a.m. to 12 p.m.

June 17, 9 a.m. to 12 p.m.

Sept. 16, 9 a.m. to 12 p.m.

Dec. 16, 9 a.m. to 12 p.m.
UCare's MSHO & MSC+ Bi-Annual Meeting recorded WebEx will be posted on the UCare website by:

March 25, 2020

June 24, 2020

Sept. 23, 2020

Dec. 23, 2020

 

 

View All Care Coordination Training Webinars

Attendance Log

 

General Care Coordination Resources & References

 

Reference & Processes

Care Coordination News Library

Certified Languages International Interpreting Services Delegate Instructions

Certified Languages International Interpreting Services Pre-Scheduling Instructions

Follow-up After Hospitalization for Mental Illness Handout (PDF)

Health Care Directives Information (PDF)

Minnesota DHS Resources & Tools

MSHO/MSC+ Additional/Supplemental Benefit Summary (New 1.1.2020)

Where to Go For Care

 

Resources 

Behavioral Health Case Management Referral Form

Care Coordination Referral Form

Culture Care Connection (external)

Dental Care for U

Disease Management Resources

Find a Doctor

Fraud, Waste & Abuse

Member Rewards & Incentives

Fitness and Wellness

Quality Initiatives

Policies & Manuals

Care Management Manual

Medical Policy

UCare Provider Manual

If you have other questions, contact the Provider Assistance Center:

612-676-3300 or 1-888-531-1493
Hours:  8 a.m. to 5 p.m.,  Monday through Friday

 

From 5 columns to 4

Service Category

 Essentia Health Provider Requirements Other EssentiaCare Network Providers

Codes Requiring Authorization - CPT/HCPC Codes

 

Outpatient Therapy (PT, OT & ST)

Includes therapy in the home and outpatient therapy provided in a nursing facility.

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Physical Therapy - Authorization required beyond threshold of 20 visits per calendar year.

Occupational Therapy - Authorization required beyond threshold of 20 visits per calendar year.

Speech Therapy - Authorization required beyond threshold of 30 visits per calendar year.

Magellan Healthcare: 
PH 952-225-5700, 
1-888-660-4705 (toll free)

Physical Therapy - Authorization required beyond threshold of 20 visits per calendar year.

Occupational Therapy - Authorization required beyond threshold of 20 visits per calendar year.

Speech Therapy - Authorization required beyond threshold of 30 visits per calendar year.

Magellan Healthcare: 
PH 952-225-5700, 
1-888-660-4705 (toll free)

 20560, 20561, 92507, 92508, 92526,
92606, 92630, 92633, 97012, 97014,
97016, 97018, 97022, 97024, 97026,
97028, 97032, 97033, 97034, 97035,
97036, 97039, 97110, 97112, 97113,
97116, 97124, 97139, 97140, 97150,
97164, 97168, 97530, 97533, 97535,
97537, 97542, 97750, 97755, 97760,
97761, 97799, G0151, G0152, G0153
       

 

 

Updated February 2020

Region

UCare Product

Eligibility

Service Area
(Minnesota Counties)

Narrow network?
North

UCare Medicare Plans (HMO-POS)

  • Essentials Rx
  • Total
  • Value
  • UCare Medicare Group Plans*
    		•

    Must have Medicare Part A & Part B to enroll

    Do not have end-stage renal disease

    		 Aitkin, Becker, Beltrami, Carlton, Cass, Clay, Clearwater, Cook, Crow Wing, Douglas, Grant, Hubbard, Itasca, Kanabec, Kittson, Koochiching, Lake, Lake of the Woods, Mahnomen, Marshall, Morrison, Norman, Otter Tail, Pennington, Pine, Polk, Red Lake, Roseau, St. Louis, Todd, Wadena, Wilkin All UCare network providers
    North

    UCare Medicare Plans (HMO-POS)

  • Classic
    		•

    Must have Medicare Part A & Part B

    Do not have end-stage renal disease

    		 Aitkin, Becker, Carlton, Cass, Clay, Cook, Crow Wing, Hubbard, Kanabec, Lake, Morrison, Pine and St. Louis All UCare network providers
    Metro

    UCare Medicare Plans (HMO-POS)

  • Prime
  • Essentials Rx
  • Complete
  • Classic
  • Total
  • Value
  • UCare Medicare Group Plans*
    		•

    Must have Medicare Part A & Part B

    Do not have end-stage renal disease

    		 Anoka, Benton, Carver, Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Ramsey, Scott, Sherburne, Stearns, Washington, Wright All UCare network providers
    South

    UCare Medicare Plans (HMO-POS)

  • Standard
  • Complete
  • Total
  • Value
  • UCare Medicare Group Plans*
    		•

    Have Medicare Part A & Part B

    Do not have end-stage renal disease

    		 Big Stone, Blue Earth, Brown, Chippewa, Cottonwood, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Jackson, Kandiyohi, Lac qui Parle, Le Sueur, Lincoln, Lyon, Martin, McLeod, Meeker, Mower, Murray, Nicollet, Nobles, Olmsted, Pipestone, Pope, Redwood, Renville, Rice, Rock, Sibley, Steele, Stevens, Swift, Traverse, Wabasha, Waseca, Watonwan, Winona, Yellow Medicine All UCare network providers
    South

    UCare Medicare Plans (HMO-POS)

  • Classic
    		•

    Have Medicare Part A & Part B

    Do not have end-stage renal disease

    		 Blue Earth, Dodge, Faribault, Fillmore, Freeborn, Goodhue, Houston, Le Sueur, Mower, Nicollet, Olmsted, Rice, Steele, Wabasha, Waseca, Watonwan, Winona All UCare network providers

    In-Network Services
    Primary Care Office Visits $0 copay $25 copay $0 copay $20 copay $0 copay $0 copay $0 copay
    Specialist Office Visits $35 copay $50 copay $20 copay $45 copay $40 copay $10 copay $35 copay
    Inpatient Hospital Care $400 copay per stay (not per day), then 100% coverage, unlimited days per admission $300 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission $250 copay per stay (not per day), then 100% coverage, unlimited days per admission $300 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission $500 copay per day (days 1 - 3), then 100% coverage, unlimited days per admission $100 copay per stay (not per day), then 100% coverage, unlimited days per admission $150 copay per day (days 1 - 5), then 100% coverage, unlimited days per admission
    Urgent Care $50 copay $45 copay $50 copay $50 copay $40 copay $0 copay $50 copay
    Worldwide Emergency Care $100 copay $90 copay $100 copay $100 copay $90 copay $100 copay $100 copay
    Medicare Part D Prescription Drug Coverage* No Prescription Drug Coverage $400 deductible | Copays based on drug tiers $200 deductible | Copays based on drug tiers $400 deductible | Copays based on drug tiers $400 deductible | Copays based on drug tiers Copays based on drug tiers $200 deductible | Copays based on drug tiers
    Preventive Dental Coverage Yes No Yes Yes Yes No No
    Vision Coverage-Routine Routine Eye Exam: 1 per year, $0 Copay Routine Eye Exam: Not Covered Routine Eye Exam: 1 per year, $0 Copay Routine Eye Exam: 1 per year, $0 Copay Routine Eye Exam: 1 per year, $0 Copay Routine Eye Exam: 1 per year, $0 Copay Routine Eye Exam: 1 per year, $0 Copay
    Vision Coverage-Diagnostic Diagnostic Eye Exam: $35 copay Diagnostic Eye Exam: $50 copay Diagnostic Eye Exam: $20 copay Diagnostic Eye Exam: $45 copay Diagnostic Eye Exam: $40 copay Diagnostic Eye Exam: $10 copay Diagnostic Eye Exam: $35 copay
    Hearing Services-Routine Routine Hearing Exam: 1 per year, $0 Copay Routine Hearing Exam: Not Covered Routine Hearing Exam: 1 per year, $0 Copay Routine Hearing Exam: 1 per year, $0 Copay Routine Hearing Exam: 1 per year, $0 Copay Routine Hearing Exam: 1 per year, $0 Copay; $500 allowed every 36 months for hearing aids Routine Hearing Exam: 1 per year, $0 Copay
    Hearing Services-Diagnostic Diagnostic Hearing Exam: $35 copay Diagnostic Hearing Exam: $50 copay Diagnostic Hearing Exam: $20 copay Diagnostic Hearing Exam: $45 copay Diagnostic Hearing Exam: $40 copay Diagnostic Hearing Exam: $10 copay Diagnostic Hearing Exam: $35 copay
    Out of Pocket Maximum $3,400 $5,000 $3,400 $3,400 $4,500 $3,000 $3,000

     

    * Part D deductible only applies to some drugs. See the Drug Formulary for details. 

    Pharmacy benefit information

    Browse 2020 Medical Authorizations

    Download the 2020 UCare Medicare Authorization and Notification Requirements