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Provider News Library
September 2021 Health Lines
Learn about our Updated Look for UCare.org/providers, UCare Provider Portal to Be Unavailable, Joy Marsh Joins UCare as Associate Vice President, Equity and Inclusion, New UCare Coverage Policies Added, September is Falls Prevention Awareness Month, New UCare Tobacco & Nicotine Quit Program for Maternity, Reminder: UCare Medicare Part D Vaccine Information, Accurate Member Information is Key to Smooth Claim Submissions, Documentation Improvement: Stroke, Ineligible Provider List Updated August 5, 2021 and more.
Quantity Limits (QL) Updated for Continuous Glucose Monitors on All UCare Formularies
Effective Sept. 1, 2021, quantity limits for continuous glucose monitor products will be updated.
Critical Business Reminders
UCare informs providers of critical business reminders for the Credentialing and Recredentialing Process, Pharmacy, Complex Case Management Process, Utilization Management Information, Member Rights and Responsibilities, Practitioner Support Shared Decision-Making Aids and Clinical Practice Guidelines.
Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting November 1, 2021, UCare is updating prior authorization criteria for 14 drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
Authorization and Notification Requirements Update:Outpatient Substance Use Disorder Services
Effective immediately, UCare will return to approving notifications for up to six months of services for outpatient subsstance use disorder (SUD) services for individual/group (H2035 or H2035HQ).
See the April 26 bulletin for details.
Reminder: UCare Medicare Part D Vaccine InformationStarting Jan. 1, 2021, UCare began denying claims for providers administering Part D vaccines in their clinics. Provider will need to bill both the vaccine and administration through the member’s Part D benefit.
See the Feb. 4 bulletin for details.
Changes to the Payment and Remittance Selection ProcessEffective immediately, UCare is changing the process to request updates to the provider’s payment and remittance selections.
Read the Dec. 18 bulletin for additional details on the changes.
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