Information for MultiPlan Network Providers
Find references below for providers who participate in the MultiPlan Medicare Advantage Networks and do NOT have a UCare Network agreement (for providers with a UCare agreement and a MultiPlan agreement, the UCare agreement will supersede). As of January 1, 2023, UCare delegates with the MultiPlan Medicare Advantage Network to provide in-network services and cost sharing for our Medicare Advantage Plan members who seek care outside of our service area. The MultiPlan logo is on the UCare Member ID card.
Resources
Prior authorization requirements will follow the guidance for member's specific Medicare Advantage Plan. Access the Authorizations page to access information related to UCare Medicare Plans.
Medical Injectable Drug Authorizations
See the Medical Injectable Drugs requiring prior authorization.
Review Medical Drug Policies.
MultiPlan providers can submit prior authorization, authorization adjustment, and pre-determination requests to UCare one of the following ways:
- Fax an authorization request form to UCare Clinical Pharmacy Intake at 612-617-3948.
- By mail to UCare, Attn: Pharmacy at P.O. Box 52, Minneapolis, MN 55440-0052.
Providers that receive a claim denial will continue to work through the provider claims appeal process using the Provider Claim Reconsideration Request Form.
See the member's ID card for plan and claim submission information.
For information on electronic claim submissions, see our Resources for Electronic Transactions page.
Access the Claims & Billing page within the Policies & Resources page from the top navigation bar.
Providers will find the following:
- Claim reconsideration form
- Payment and remittance information
- MultiPlan Medicare Advantage providers will be reimbursed at the contracted MultiPlan rate. This will be identified on your remittance.
- For providers with a UCare agreement and a MultiPlan agreement, the UCare agreement will supersede.
- Taxonomy requirements
- UCare relies on provider-submitted taxonomy for accurate and timely claims processing. Whenever an NPI is submitted (billing or rendering), taxonomy must also be submitted. Claims that do not have taxonomy submitted when using an NPI will reject. - Third-party billing information
Contact MultiPlan to receive information on credentialing.
Email: govtcoordination@multiplan.com
Fax: 630-799-3578
Mail: MultiPlan, ATTN: GBSC, 6116 Shallowford Road, Suite 109B, Chattanooga, TN 37421
Contact MultiPlan to receive information on participation status and provider agreement.
Email: govtcoordination@multiplan.com
Fax: 630-799-3578
Mail: MultiPlan, ATTN: GBSC, 6116 Shallowford Road, Suite 109B, Chattanooga, TN 37421
Contact MultiPlan to receive information on managing your information.
Email: govtcoordination@multiplan.com
Fax: 630-799-3578
Mail: MultiPlan, ATTN: GBSC, 6116 Shallowford Road, Suite 109B, Chattanooga, TN 37421
See the member's ID card for plan information. For questions about patient benefits, eligibility and pre-certification, contact UCare's Provider Assistance Center at 612-676-3000 or 1-888-531-1493 8 am - 5 pm CST, Monday through Friday.
Contact the Provider Assistance Center (PAC) at 612-676-3300 or 1-888-531-1493 toll-free, Monday through Friday from 8 am-5 pm CST, or send a secure message through the UCare Provider Portal (coming soon).
PAC is a resource for providers. They help callers with the following:
- Claim status
- Eligibility questions
- Benefit information
- Prior authorization inquires
Access the Provider News page from the top navigation bar.
Provider bulletins and monthly provider newsletters are the primary way we communicate important information to providers. MultiPlan providers who see multiple UCare members may want to sign-up to receive these emailed communications.
The Provider News library is a searchable archive of news.
Currently, MultiPlan Providers do not have access to the UCare Provider Portal. We will update this page once access is available. In the meantime, please contact the Provider Assistance Center (PAC) at 612-676-3300 or 1-888-531-1493 toll-free, Monday through Friday from 8am-5pm CST.