UCare - Providers - Past Announcements

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› Minnesota Law Mandates Electronic Health Care Transaction in 2009 - Eligibility Inquiry and Response (270/271)

› Minnesota Law Mandates Electronic Health Care Transaction in 2009 - Electronic Claim Submission (837) effective 7/15/09

› Important Update from UCare Regarding Medicare Part D Vaccine and Administration Reimbursement

2009 Year-End Blood Lead Screening Incentive

To help UCare members in for their blood lead test before Dec. 31, 2009, UCare is offering a year-end provider incentive of $100 for each qualifying lead test done between Nov. 1 2009 - Dec. 31, 2009. To find out more information about this, click on the introduction letter and flyer links below.

Introduction letter: A message from our Chief Medical Officer, Barry Baines, M.D.

Flyer: Information regarding eligibility, deadline for claim submission, and coding/billing

Please note: UCare also offers a lead test voucher for a $25 gift certificate to our members as part of our Health Promotions member incentives. This lead test voucher is good for members who are currently on UCare and have had one lead test at age 12 or 24 months. Providers can make copies of this form anytime by clicking on the link below and use it while the patient is in your office.

Click here for the UCare Lead Test Voucher for members.

EDI Claim Rejections from PCA Agencies
Recently, UCare has noticed an increase in EDI claim rejections from PCA Agencies. The analysis of the rejections concludes the following reasons why the claims are being rejected. The PCA Agency will need to include either the PCA’s UMPI number, UCare Group Practice number (one alpha and three digit numbers, e.g. Z194), and/or the NPI number when submitting EDI claims.

If you are a PCA Agency and have noticed that your EDI claims are being rejected, please review the report to see if any of the information above is missing and then resubmit your claim(s) if it is. If you have any questions, please call the Provider Assistance Center.

Published 12/17/09

Provider Alert: Applying Co-pays for Vision Services in Error

UCare has identified an error in applying specialist office visit co-pays for vision services for our UCare for Seniors members. This affected claims that were finalized with dates of services in 2009 from vision providers.

We have identified all the vision service claims that were assessed a co-pay in error and have reprocessed all of them as of today, 10/26/09. Vision providers will receive future explanation of payments (EOPs) showing the adjustment and payment of the co-pays.

If you are a vision provider and have collected co-pay(s) from a UCare for Seniors member, we apologize for the inconvenience and you should reimburse the patient(s) back their money.

Please call our Provider Assistance Center at the phone number(s) listed above.

(Posted 10/26/09)

Home Assessments

UCare is pleased to announce a new outreach initiative for our high-risk UCare for Seniors and Minnesota Senior Health Options (MSHO) members. These members may choose to receive a free Health Risk Assessment (HRA) in their home administered by a physician or nurse practitioner starting in September.

UCare has contracted with Matrix Medical Network to schedule the appointments with our members and provide the in-home assessment. The program is part of our ongoing efforts and is designed to support the care that is being provided by the member’s primary care physician (PCP). These home assessments are not intended to replace any existing appointments the member may have with their PCP and not meant to replace the care they receive through their PCP. However, a copy of the completed assessment will be provided to the member’s PCP for review.

If there are any questions, please call our Provider Assistance Center at 612-676-3300 or 1-888-531-1493 toll free.

(Posted 8/27/09)

Provider Alert: Potential Claim Payment Error

UCare recently identified an error in adjudication for claims processed between the dates 7/10/09 - 7/16/09. This has created an environment in which incorrect providers may have been paid. UCare has corrected the error and we apologize for the inconvenience this may cause.

Claims that were affected by the payment error have been identified and currently being adjusted.

(Updated 8/27/09)

Electronic Attachments, Appeals Take Effect July 15

Claims are not the only documents that must be electronically submitted beginning July 15. Paper attachments or adjustments/appeals to a claim will have to be submitted electronically, too.

UCare has set up a designated fax number that will ease providers' submission of any attachments and/or adjustments/appeals information associated with electronic claims. The designated fax number is
612-884-2261.

Quick Reference Sheet: Claim Submission

This quick reference sheet provides an outline of the Minnesota State statute, section 62J.536, for electronic claim submissions. Also, provided in this document are a list of the clearinghouses that UCare currently contracts with, and information of how to and where to submit electronic claim attachments to UCare. Click here to download the document.

(Posted 6/19/09)

Waiver Obligation Processing - *Updated 5/26/09*

UCare has identified an error in the application of the waiver obligation amounts for some Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) claims. UCare's system have been updated and claims that require adjustments have been identified. Claims requiring adjustments will be completed by June 26, 2009. Your UCare explanation of payments will reflect the adjustments after June 26.

ALERT: For providers and pharmacies serving all UCare members in Minnesota re: Federal Disaster/Emergency Declarations
*Expired*

EW Service Providers Billing for Metro Area MSC+ Enrollees

Minnesota Senior Care Plus (MSC+) will replace Minnesota Senior Care (MSC) in the seven county metro area effective 1/1/09. UCare is one of five health plans that DHS currently contracts with to provide health care services to MSC+ members. Recipients eligible for Elderly Waiver (EW) services receive authorization and care coordination of waiver services for MSC+ through UCare or UCare’s delegate. Providers offering EW services to MSC+ enrollees must bill UCare for payment.

UCare’s Plan Design Changes Summary for 2009

Announcing UCare’s Plan Design Changes Summary 2009 for Medicare Advantage, UCare Connect, UCare Complete, and Minnesota Senior Health Options (MSHO) effective 01/01/09.

› For more information please click here

Interactive Voice Response (IVR) System (12/26/08)

Staying consistent with UCare's commitment to provide excellent service to you as a valued provider, UCare has launched an IVR system to offer our providers the opportunity to use self-service features to verify a member’s eligibility or to check the status of a claim. Using your touch tone phone, you will have easy access to a provider’s two most common questions 24 hours a day, 7 days a week.

- For quick service of eligibility inquiries, have the individual’s personal member identification (PMI) or UCare member ID number and their date of birth ready.

- For quick service on claim status inquires, have your NPI number, UCare member ID, and the claim date of service information ready.

Notice: Effective 10/01/08 Change in Medicare Part D Vaccine Administration Reimbursement

The Center for Medicare and Medicaid Services (CMS) set forth changes to the payment policy for the administration costs associated with Medicare Part D covered vaccines beginning 01/01/08. This change requires the payment for the administration costs associated with Part D covered vaccines to be submitted to the Part D plan for reimbursement.

› For more information please click here

› Important Update from UCare Regarding Medicare Part D Vaccine and Administration Reimbursement

Attention: Contracted Personal Care Attendant Organizations and PCA Choice Providers

RE: Billing PCA services using NPI & UMPI numbers

Effective October 1, 2008, UCare will require all Personal Care Attendant (PCA) providers to start billing with the individual UMPI numbers for each of their PCA's. See below for more information outlining the requirements when billing for these services.

› For more information please click here

UCare partners with Edgepark Medical Supplies

UCare is pleased to announce our new partnership with Edgepark Medical Supplies to provide nationwide home delivery of medical supplies to all of our members. Edgepark, a family owned, independent home medical supplier, offers outstanding service and value, as well as quick and convenient access to an inventory of more than 30,000 high-quality medical supplies.

› For more information please click here

UCare is pleased to announce CuraScript (Specialty) Pharmacy Inc.

CuraScript was recently chosen as our exclusive provider for specialty medications. CuraScript is a leading, full-service specialty pharmacy that provides personalized care to each patient.

› For more information please click here
› CuraScript Enrollment Form

Notice: Adoption of Standards for the Use of the Uniform Paper Explanation of Benefits and Uniform Paper Remittance Advice Report

The UCare Explanation of Payment (EOP) has been revised per Minnesota Statutes, section 62J.581. Additional information regarding the Adoption of Rules may be found here http://health.state.mn.us/auc/eobremitmanual2007.pdf

› UCare Explanation of Payment (EOP) Reference Guide

Notice: The following form revisions were authorized by the Centers for Medicare & Medicaid Services (CMS) and require immediate implementation

› UCare Revision Notice Letter

›  Notice of Medicare Non-Coverage (NOMNC) Instructions
›  Revised Notice of Medicare Non-Coverage (NOMNC) (Minnesota)
›  Revised Notice of Medicare Non-Coverage (NOMNC) (Wisconsin)
›  Revised Detailed Explanation of Non-Coverage (DENC)
›  Revised Notice of Denial of Medical Coverage (NDMC)

Note: If you are unable to open form: Right-Click on form; Go to "Save Target As..."; Save to your computer.

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