News & Alerts
Provider News Library
UCare Implements Virtual Hold For Providers
Beginning Thursday, June 23, providers may use virtual hold technology when calling UCare’s Provider Assistance Center (PAC).
FDA Approval of Ukoniq Withdrawn Due to Safety ConcernsDue to safety concerns, the U.S. Food and Drug Administration (FDA) announced on June 1, 2022, it has withdrawn approval for the cancer medicine Ukoniq (umbralisib).
See the June 22 Provider Bulletin for details.
Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting August 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.
UCare Updates Regarding 1115 Substance Use Disorder System Reform Demonstration
On March 24, 2022, UCare received formal notification from the Minnesota Department of Human Services (DHS) that the Centers for Medicare and Medicaid Services (CMS) approved proposed changes for the 1115 Substance User Disorder System Reform Demonstration.
Fax Services to be UnavailableDue to a technology upgrade, UCare will be unable to accept faxes between 6 pm, June 21 and 2 am, June 22. Please plan to send any faxes before or after that timeframe.
UCare to Deny Claims When Comprehensive Procedure Code is Not Applied
As a reminder, providers are required to bill the most comprehensive code for procedures versus individual (component) codes. Effective for claims received on or after June 28, 2022, UCare will apply edits to deny claims when the most comprehensive code is not billed.
June 2022 Health Lines
Learn about the following: Dental Access for Members, Documentation Improvement: Obesity and Body Mass Index (BMI), Ineligible Provider List Updated, Telehealth Billing Education, and Upcoming Holidays.
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.
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.
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.