*UCare Medicare Plans include Prime, Value, Essentials Rx, Standard, Complete, Classic and Total.
UCare Individual & Family Plans include Bronze, Bronze HSA, Silver, Silver HSA, Core, Gold and
UCare Individual & Family Plans with M Health Fairview Bronze, Bronze HSA, Silver, Silver HSA.
The Behavioral Health Case Management Referral Form is completed when you have a UCare PMAP, MNCare, MSHO or MSC+ member who has a complex Behavioral Health condition.
Behavioral Health Case Management Referral Form (New 10.11.19)
The Care Management Referral form is completed when you have a member/patient who you feel would benefit from care coordination services and is actively enrolled in UCare Connect, UCare Connect + Medicare, PMAP (under 65), UCare Medicare Plans or Individual & Family Plans.
The Complex Case Management Referral form is completed when you have a medically complex member/patient who you feel would benefit from short term / intensive medical case management. They typically have a new critical medical event, multiple medical diagnoses with challenges or high medical costs/utilization. This program is for UCare Medicare and Individual & Family Plans and PMAP/MNCare.
UCare works with delegated organizations to handle the following types of authorization.
Direct all authorization questions to UCare's delegate, Fulcrum Health, Inc. | 1-877-886-4941
Direct all authorization questions to UCare's delegate, Delta Dental of Minnesota
UCare State Public Programs: 1-855-648-1415 toll free or 651-768-1415
UCare Medicare Plans (Medicare Advantage): 1-855-648-1416 toll free or 651-768-1416
UCare Individual & Family Plans / UCare Individual & Family Plans with M Health Fairview: 1-855-648-1417 toll free or 651-768-1417
EssentiaCare: 1-855-648-1416 toll free or 651-768-1416
Medical Injectable Drug Authorizations:
Direct all authorization requests to UCare’s delegate: Care Continuum, a subsidiary of Express Scripts Online (ePA) at www.express-path.com/ | Phone: 1-800-818-6747 | Fax: 1-877-266-1871
Therapy - PT, OT, ST Authorization:
Direct all authorization questions to UCare's delegate, Magellan Healthcare, Inc. | 952-225-5700, 1-888-660-4705 | 1-888-656-1952 (fax)
In order for services to be eligible for payment by UCare, the services must meet UCare’s standards for coverage, including medical necessity criteria. Coverage and benefits vary significantly among different UCare plans. Member Handbook or Member Contracts specific to the member’s UCare plan.
Find drug coverage for each UCare health plan and forms to request exceptions or authorizations on our Pharmacy page.
Find medical injectable drug prior authorization information for each UCare health plan and forms to request authorizations on our Pharmacy page.
The Formularies page on the UCare provider website shows which drugs are covered, as well as everything you need to request exceptions or prior authorization.
This form is intended to communicate patient referrals between medical and behavioral health providers.
612-676-3300 or 1-888-531-1493
Hours: 8 a.m. to 5 p.m., Monday through Friday
UCare is committed to protect our members and the community from the spread of coronavirus (COVID-19). The COVID-19 situation is changing quickly, and we are monitoring changes closely. To assist our provider partners in navigating this changing situation, UCare has created a COVID-19 Information for Health Care Providers page on our Provider Website.
In November 2019, UCare issued a Provider Bulletin requiring Medicare Certified Home Health Care providers to submit claims in accordance with CMS billing guidelines. A new bulletin has been issued to provide additional clarification.
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. UCare has prepared a Provider Bulletin outlining the key updates.
Go to the 2020 Provider Manual
The FDA requested a market withdrawal of all remaining OTC and prescription ranitidine drugs due to an impurity detected in the products.
Read the Market Withdrawal bulletin for additional information.
UCare is temporarily changing prior authorization and notification requirements for certain post-acute care services effective for dates of services April 20, 2020, to June 30, 2020, in response to COVID-19.
UCare’s Pharmacy Department has been closely monitoring the COVID-19 developments and taking appropriate action to ensure our members have access to medication.
Receive our monthly newsletter and bulletins with timely updates from UCare right to your inbox.SIGN UP