Claims & Billing

 

Check the Status of a Claim

Claim Lookup

Search for Remittance Advice

Payment Lookup

Minnesota based non-contracted providers who deliver services to a UCare member will need to follow the process below before submitting a claim to UCare:

  1. Submit the Add or update a facility or location form to get enrolled in UCare’s payment system. A confirmation number will be provided confirming your submission.
  2. Within 30 business days you will receive an email notification from us confirming you have been added to UCare’s payment system.
  3. Submit your claim(s) electronically to UCare.  

 

IMPORTANT NOTES:  

  • Guidance for electronic claim submission is provided in Electronic Data Interchange chapter of the UCare Provider Manual.
  • UCare requires Healthcare Provider Taxonomy Code Sets (HPTC), maintained by the National Uniform Claim Committee (NUCC), be included on all claims. For more information see Electronic Data Interchange chapter in the UCare Provider Manual.
  • This process does not add your organization to UCare's contracted provider network. Please see “Join Our Network if interested in becoming a contracted provider with UCare.   

Non-contracted providers who practice outside of Minnesota but deliver services to a UCare member will need to follow the mail or online process listed below before submitting a claim to UCare:

IMPORTANT NOTE:  

  • UCare requires Healthcare Provider Taxonomy Code Sets (HPTC), maintained by the National Uniform Claim Committee (NUCC), be included on all claims.
  • This process does not add your organization to UCare's contracted provider network. Please see the “Join Our Network” page if interested in becoming a UCare contracted provider.   

Mail:

  1. Send a copy of the paper claim(s), along with completed W-9 to:

UCare
Attention: Claims
P.O. Box 70
Minneapolis, MN 55440-0070

Click here to download a Printable W-9 .

  1. Guidance for paper claims submission is provided in Claims & Payment chapter of UCare’s Provider Manual.

Online:

  1. Submit the Add or update facility or location form to get enrolled in UCare's payment system. A confirmation number will be provided confirming your submission.
  2. Within 30 business days you will receive an email notification from us confirming you have been added to UCare's payment system.
  3. Submit your claim(s) electronically to UCare. Guidance for electronic claims submission is provided in Electronic Data Interchange chapter of UCare's Provider Manual. 

 

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

612-676-3300 or 1-888-531-1493 (toll free)
Hours:  8 am to 5 pm,  Monday through Friday

Newsletters & Alerts

 

See Full Provider News Library

Pharmacy Access- Disruption Due to Protests

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.

 

 

.

Updated Prior Authorization Criteria for Drugs on the IFP Formulary

Starting June 1, 2021, UCare is updating prior authorization criteria for 21 drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary. 

See the April 12 bulletin for details.

 

 

.

Monoclonal Antibody Treatments for COVID-19

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.

 

 

 

April 2021 Health Lines

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.

Read the April 2021 Health Lines.

 

.

REMINDER: Medicare Services Must Be Provided and Billed By Eligible Medicare Provider Types

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.

 

 

 

Updated Prior Authorization Criteria for Drugs on the IFP Formulary

Starting May 1, 2021, UCare is updating prior authorization criteria for 11 drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary. 

See the March 11 bulletin for details.

 

 

.

2021 Update to UCare's Provider Manual

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.

Read the Provider Bulletin.

Go to the Provider Manual.

 

 

 

Updated Prior Authorization Criteria for Drugs on the IFP Formulary

Starting April 1, 2021, UCare is updating prior authorization criteria for 14 drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary. 

See the Feb. 15 bulletin for details.

 

 

.

Changes to the Payment and Remittance Selection Process

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.

 

 

 

2021 Code and Editing Updates

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.

 

 

.

Previous Next

Q4 2020 Update to UCare's Provider Manual

UCare’s 2020 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 2020 Provider Manual page.  

 

 

Previous Next