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Provider News Library
Appointment Availability Assessments
Periodically, UCare selects a random sample of its provider network locations and calls to survey next available appointment for specific provider types. UCare will perform this assessment between Friday, May 20 and Friday, June 10. The assessments help to ensure the network can provide care to UCare members in a timely manner.
To learn more about UCare’s appointment availability standards, please refer to section 5-1 of the UCare Provider Manual.
This information is also available in a Provider Bulletin.
Inappropriate Rejection of Some PCA Claims
UCare has identified that some Personal Care Assistant (PCA) claims are experiencing inappropriate rejections for 2022 dates of service.
Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting July 1, 2022, UCare is updating prior authorization criteria for six drugs that are on the UCare Individual & Family Plans and UCare Individual & Family Plans with M Health Fairview formulary.
Additional Claims Payment Run Has Ended
UCare has ended the temporary third claims payment run on Tuesdays and has returned to its standard Wednesday and Friday payment runs.
Practitioner Credentialing and Claims Setup
UCare has updated its notification process for newly credentialed practitioners. Providers will now receive one letter confirming practitioner credentialing and claims setup instead of two. The new letter will confirm credentialing and instruct providers to wait 30 days to bill to ensure setup in our claims system has been completed. As a reminder, claims sent before the practitioner has been set up in UCare’s claims system will pend until setup is completed.
This information is also available in the May 12 Provider Bulletin.
May 2022 Health Lines
Learn about the following: Q2 2022 Provider Manual Update, Working with UCare, Mental Health Workforce, Minnesota's Community Resource Hubs and more.
UCare Provider Manual Updated for Q2 2022UCare’s 2022 Provider Manual contains critical information that providers need to know to effectively work with UCare and our members. It is important that providers reference the online manual regularly for up-to-date content. The Provider Manual has been updated to reflect current business practices.
Go to the Provider Manual.
Transportation Services for Medical Appointments
UCare offers transportation to and from medical appointments for eligible members when scheduled with at least 48 hours notice. Same-day rides or next-day rides are limited to more urgent situations.See the May 2 Provider Bulletin for details.
Some 277CA Files to be Re-Transmitted
UCare recently identified some 2022 claims were not listed on 277CA (claims acknowledgement) files transmitted for 837 claim submissions.
Updated Email Requirements for Multiple Claims Inquiries
Provider Assistance Center (PAC) updated the email submission requirements for multiple claims inquiries.
See the April 18 Provider Bulletin for details.
Authorization and Notification Requirements Update: Withdrawal Management
On April 1, 2022, UCare removed Withdrawal Management from the Mental Health and Substance Use Disorder Services Authorization and Notification requirements grid for members enrolled in State Public Programs or an Individual and Family Plan.
2022 Summer Camps Available for Young UCare Members
UCare has teamed up with Minnesota camps to offer summer camp opportunities for young Prepaid Medical Assistance Program (PMAP) and MinnesotaCare (MnCare) members. The camps are offered at no cost to eligible UCare members. We encourage providers to share camp details with eligible patients.
Information on UCare’s New Claims SystemSee all related Provider Bulletins outlining the changes you can expect with UCare’s new claims system. Visit the New Claims System page.
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.
Give Us a Call
Provider Assistance Center:
612-676-3300 or 1-888-531-1493
Hours: 8 am – 5 pm, Monday – Friday
Report Fraud, Waste and Abuse:
Send Us a Fax or Email
Claims Attachments: 612-884-2261
Claims Adjustments: 612-884-2186
Prior Authorization Requests:
612-884-2499 or 1-866-610-7215
Rate Updates (CAH, RHC, FQHC): RateLetters@UCare.org