March 2019 edition of the Health Lines Provider Newsletter
In this edition, read the upated alert for the Online Submission of the Claims Reconsideration Request Form Delay, 2019 UCare Provider Manual update, Provider FAQs – New UCare Claims System, Healthy Saving Discount program, and documentation for Deep Vein Thrombosis (DVT).
Additional Enrollment Opportunities for MedicareMembers
Medicare-eligible individuals have multiple opportunities to enroll in the most appropriate plan to meet their needs.
We’ve prepared a Provider Bulletin to help explain the following enrollment periods:
Special Enrollment Period (SEP) - Dec. 8, 2018 to Feb. 28, 2019
Medicare Advantage Open Enrollment Period - Jan. 1, 2019 to March 31, 2019
2019 Pharmacy Formulary update
This bulletin provides a summary of the UCare pharmacy formulary changes taking effect Jan. 1, 2019. Plan names have changed for 2019 for Medicare plans and Individual & Family plans.
UCare's 2019 authorization and notification requirements are now available on our website at ucare.org/providers, under the Eligibility & Authorization section: State and Public programs, UCare Medicare Pans, EssentiaCare, Behavioral Health and Pharmacy.
UCare to Suspend Authorizations in 2019 For UCare Choices Plans
During 2019, UCare will temporarily suspend the requirement for prior authorizations for services delivered to members with UCare Choices and Fairview UCare Choices (renamed as UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview in 2019).
UCare Choices Plans Claims Submission Changes for 2019
Effective January 1, 2019, UCare will make changes that affect claims submission for onlyUCare Choices and Fairview UCare Choices plans (to be renamed UCare Individual & Family Plans and UCare Individual & Family Plans with Fairview on January 1, 2019).
UCare informs providers of critical business reminders for NCQA accreditation requirements for Credentialing, Pharmacy, Complex Case Management, Utilization Management, Member Rights and Responsibilities, and Disease Management.