Claims Processing Changes for Part D Drugs Effective 8/1/10
Effective 8/1/10, UCare no longer reimburses for Part D drugs and the administration of Part D drugs for claims submitted to us by a health care provider. UCare follows the CMS guidelines and criteria for drugs that are usually self-administered. We encourage our members to receive their Part D drugs and administration at the pharmacy. This guarantees that members are charged for their Part D co-pay only and result in a lower out-of-pocket cost.
For additional information, please download a copy of our health lines BULLETIN (2010 Pharmacy Updates, including Part D Drugs) by clicking on the link.
Published 8/16/10
UCare Restricted Recipient Program Announcement
Click here to read more about the importance of this program.
Published 6/30/10
Electronic Claim Submission Requirement Effective July 1, 2010
Effective July 1, 2010, UCare will no longer accept the submission of professional and institutional paper claims, according to the Minnesota State Statute 62J.536.
Click here to read more about the requirements and actions you need to take in order to avoid return of paper claims and processing delays. This health lines BULLETIN is particularly important to providers who currently submit paper claims.
Published 5/19/10
Important notice to providers who are serving UCare members in Northwestern Minnesota - EXPIRED
Click here to read UCare's notice to providers in the areas affected by this federal emergency declaration.
Published 3/25/10
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 612-676-3300 or 888-531-1493 (toll free) if you have any questions or concerns. Thank you.
(Posted 10/26/09)
(Updated 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.