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Provider Manual

UCare's Provider Manual is an extension of your contractual obligations.  Checking it regularly for up-to-date information and reference material is required.  Please reference Chapter 1 for an outline of Provider responsibilities beyond your contract.  

1. Introduction to UCare 

Updated November 2015​

10. Hospital Services

Updated November 2015​

19. Culturally Responsive Care

Updated November 2015 ​

2. Member Enrollment & Eligibility

Updated November 2015

11. Interpreter Services

Updated November 2015

20. Delegated Business Services

Updated November 2015​

3. Sales & Marketing

Updated November 2015 ​

12.Transportation Services  

Updated November 2015

21. Point-of-Service (POS) - UCare for Seniors

Updated November 2015 ​

4. Benefits Overview

Updated November 2015 ​

13. Provider Resources for Child & Teen Checkups

Updated November 2015​

22. Compliance and Fraud, Waste, and Abuse

Updated November 2015​

5. Authorization & Notification Standards  

Updated November 2015 ​

14. Obstetrics and Gynecology

Updated November 2015 ​

23. Medical Necessity Criteria

Updated November 2015 ​

6. Claims and Payment  

Updated November 2015​

15. Comprehensive Outpatient Rehabilitation Facility Services

Updated November 2015​

24. Clinical Practice Guidelines

Updated November 2015​

7. Nursing Facility Services

Updated November 2015

16. Quality Program

Updated November 2015​

25. Health Promotion Programs

Updated November 2015 ​

8. Home Care Services

Updated November 2015

17. Provider Enrollment

Updated November 2015 ​

26. HCBS Waiver Services

Updated November 2015​

9. Public Health Services

Updated November 2015 ​

18. Member Complaints, Appeals & Grievances

Updated November 2015 ​

27. Restricted Recipient/ Restricted Member Program 

Updated November 2015