Join Our Network

 

Are you a new UCare provider? Click here for information and resources to help you get started.

  • Fill the forms out as instructed and use the UCare Contracting Checklist to ensure all documents are submitted. 
  • Missing and/or incomplete information may result in processing delays and/or closure of your request. 
  • Be sure to keep the files in the same format to prevent delays in processing your application.
  • Please complete forms electronically (download form, type in answers and save). Handwritten forms will be returned. 

1. Download the Contracting Request Forms  

All Provider Types must complete the following forms:

UCare Contract Intake Form  (XLS)

Site/Practitioner List  (XLS)

Disclosure of Ownership Form  (PDF)

Provider Directory & Subdirectory Questionnaire (PDF)

W-9  (PDF)

Certificate of Insurance (COI): You will need to contact your insurance carrier to obtain copies.

Additional Forms for Medicare Certified Providers:

FDR Attestation (PDF)

FDR Compliance Program Requirements (PDF)

Additional Forms for Mental Health Providers:

Behavioral Health Survey (XLS)

Additional Forms for Transportation Providers:

Current Vehicle Certification from MNDOT: You will need a copy of your current Vehicle Certification from Minnesota Department of Transportation (MNDOT).


2. Attach all required contracting request documents to an email and send to providerapp@ucare.org.

3. For contracting request questions, please email providerapp@ucare.org. 

 

Important notes:

  • In some cases, you must also be credentialed and approved. See Credentialing information.
  • Before seeing UCare members, you must receive a contract effective date from UCare. Seeing UCare members prior to the contract effective date and the credentialing approval date (if applicable) will result in out-of-network claim processing, claim rejections or claim denials.
  • Submitting a contracting request does not guarantee enrollment as a participating UCare provider.
  1. Once we have received all your documents for the contracting request, we will need up to 90 days to process the request.

  2. During this review, you should start the credentialing process, if credentialing is required.

  3. UCare's contracting department will reach out to you to initiate the contracting process if a decision is made to contract with your organization. UCare will notify you in writing if the decision is made to not contract with your organization.

  4. You will be notified via email when the full provider enrollment process is complete - contracting and credentialing (if needed) - and you can see members.

  5. UCare will notify you if we are denying your request. If your contract application is denied, you will receive a communication from UCare providing instructions for appealing this decision.  All appeals must include new information that was not contained within the initial request, along with detailed documentation outlining why UCare should reconsider its determination.

Frequently Asked Questions

 

If you are having difficulty downloading contracting forms, please send an email to providerapp@ucare.org with the subject "Having Difficulty Downloading Forms."

UCare requires all contracted providers with assigned National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) to be registered with the Minnesota Department of Human Services. Information regarding registration can be found on the MHCP Enrolled Providers page, under “MHCP Provider Requirements.”

If you have questions on the registration process or other questions for DHS, please call the DHS Information Desk at 651-431-2000.

You may not begin seeing members until the contract effective date. The contract effective date will generally be determined by UCare once the signed contract is received from the provider. Providing services to UCare members before you are contracted can result in denied claims.

For providers that also require credentialing, providing services to UCare members before you are both contracted and credentialed can result in denied claims. Please note that each practitioner within your practice will have his/her own credentialing approval date. These dates may vary across practitioners, even if they are part of the same practice.

The credentialing approval date with UCare cannot be backdated or changed from the date that is listed in the approval letter from UCare. Services provided to members prior to this approval date and the contract effective date can result in denied claims.

Providers who have opted-out or are not enrolled with Medicare, may not provide services to members enrolled in UCare Medicare Plans. Additionally, UCare follows CMS and MHCP eligibility and billing guidelines respectively to determine service coverage. Providers eligible for Medicare coverage may choose to opt-out or not enroll in Medicare. However, for dually eligible members, UCare will not reimburse services covered by, but not billed to, Medicare because the provider has chosen not to enroll in Medicare. For additional information on opt-out Providers, please visit the MN Department of Human Services Provider Manual to review Medicare and Other Insurance requirements.  

When a member has other insurance primary to UCare, it is the provider’s responsibility to bill all third-party liability “TPL” payers and receive payment to the fullest extent possible before billing UCare.


 

 

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

 

Step 1

Make sure the UCare network in your
area is open.

Step 2

Download and complete the
forms as specified.

Step 3

Submit the required forms to UCare.

First, see if the network is open

 

Before you apply, check the status of our network to ensure we are open in your area.
To ensure accurate results, begin typing your Minnesota county and then select the appropriate county name from the auto-generated list.

 

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