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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 October 2014 

10. Hospital Services

Updated October 2014​

19. Culturally Responsive Care

Updated October 2014 ​

2. Member Enrollment & Eligibility

Updated October 2014

11. Interpreter Services

Updated October 2014

20. Delegated Business Services

Updated October 2014​

3. Sales & Marketing

Updated October 2014 ​

12.Transportation Services  

Updated January 2015

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

Updated October 2014 ​

4. Benefits Overview

Updated October 2014 ​

13. Provider Resources for Child & Teen Checkups and Blood Lead Testing

Updated October 2014​

22. Compliance and Fraud, Waste, and Abuse

Updated October 2014 ​

5. Authorization & Notification Standards  

Updated October 2014 ​

14. Obstetrics and Gynecology

Updated October 2014 ​

23. Medical Necessity Criteria

Updated October 2014 ​

6. Claims and Payment  

Updated October 2014 ​

15. Comprehensive Outpatient Rehabilitation Facility Services

Updated October 2014 ​

24. Clinical Practice Guidelines

Updated October 2014​

7. Nursing Facility Services

Updated October 2014

16. Quality Program

Updated October 2014 ​

25. Health Promotion Programs

Updated December 2014 ​

8. Home Care Services

Updated October 2014

17. Provider Enrollment

Updated October 2014 ​

26. HCBS Waiver Services

Updated October 2014 ​

9. Public Health Services

Updated October 2014 ​

18. Member Complaints, Appeals & Grievances

Updated October 2014 ​

27. Restricted Recipient/ Restricted Member Program 

Updated October 2014