Medicare Advantage Plans - Pharmacy

 

The Pharmacy Benefit Manager (PBM) for all UCare members is Express Scripts, Inc. (ESI).  

UCare Medicare Plans | UCare Medicare Group Plans | EssentiaCare | 
UCare Medicare Plans with M Health Fairview & North Memorial 

 

ePA is the preferred method to submit Prior Authorization requests to Express Scripts for pharmacy benefit drugs. Providers may use ePA through ExpressPAth, Sure Scripts, CoverMyMeds or through the Electronic Health Record.

Starting Jan. 1, 2020, prior authorization requests for medical drugs administered in a doctor's office will be reviewed by Care Continuum, a subsidiary of Express Scripts. See information in Medical Injectable Drug Prior Authorization Resources. 

2019
 
2020

Beginning Jan. 1, 2020, Care Continuum, a subsidiary of Express Scripts, will review Medical Drug Prior Authorization requests for all UCare plans See the 2020 Drug PA bulletin.     

Submit an authorization request, on or after Jan. 1, 2020 using one of the following ways:
  • Online (ePA) via the ExpressPAth Portal at https:www.express-path.com/. Providers can submit requests, check on the status of submitted requests, and submit an authorization renewal on the ExpressPAth Portal. The site also provides 24/7 access, potential for real-time approvals, and email notifications once a decision is reached.
  • Fax an authorization form to Care Continuum at 1-877-266-1871.
  • Call Care Continuum at 1-800-818-6747. 

Non-participating providers should send requests using this form

  • by fax to UCare Clinical Services at 612-884-2300.
  • or by mail to UCare, Attn: Clinical Services at P.O. Box 52, Minneapolis, MN 55440-0052.

Providers wanting to make an adjustment to an existing prior authorization

  • should contact UCare Clinical Services – for 2019 prior authorization changes.
  • should contact CareContinuum – for 2020 prior authorization changes.

Providers that received a claim denial due to no authorization in place will continue to work through the provider claims appeal process using the Provider Claim Reconsideration Request Form.

Pharmacy Benefit Prior Authorization

Express Scripts
Phone: 1-877-558-7521
Fax: 1-877-251-5896 
 

Medical Injectable Drug Prior Authorization

Care Continuum, a subsidiary of Express Scripts
Online (ePA): ExpressPAth Portal at www.express-path.com/.
Phone: 1-800-818-6747 
Fax: 1-877-266-1871

UCare Clinical Services Intake
Fax: 612-884-2300

Specialty Pharmacy Contact Information

Fairview Specialty Pharmacy
Phone: 612-672-5260 or 1-800-595-7140 toll free
Fax: 1-866-347-4939
www.fairviewspecialtyrx.org/

Accredo
www.accredo.com

Mail Order Contact Information

Express Scripts Mail Order Pharmacy
Phone: 1-866-544-7950  
Fax: 1-800-837-0959  
ePrescribing: Express Scripts Home Delivery Pharmacy  
 

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

Q2 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. UCare has prepared a Provider Bulletin outlining the key updates.

Go to the  2020 Provider Manual    

  

 

UCare Implements New Transportation Management Software

UCare has rolled out a new transportation system to schedule rides for our members. The new service will continue to be called UCare HealthRide.

 

Read the June 22 Provider Bulletin.