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Frequently Asked Questions
UCare requires all contracted providers with an assigned NPI to be registered with the Minnesota DHS. Find registration information on the MHCP Enrolled Providers page, under “MHCP Provider Requirements.” Direct questions to the DHS Information Desk at 651-431-2000.
If the provider type does not have an NPI, a provider can enroll without a provider identification number and MHCP will assign them an UMPI when Provider Eligibility and Compliance processes the application.
NPI
Find registration information on the NPPES site.
You can see members after the contract's effective date. This date is generally determined by UCare once the signed contract is received from the provider. If a provider provides services to a UCare member before the provider is contracted, this could result in denied claims.
For providers who also require credentialing, providing services to UCare members before being both contracted and credentialed can result in denied claims. Note: each practitioner within a practice will have his or her own credentialing approval date. These dates may vary across practitioners, even if they are part of the same practice.
The credentialing approval date with UCare cannot be backdated or changed from the date that is listed in the approval letter from UCare. Services provided to members prior to this approval date and the contract effective date can result in denied claims.
For providers who also require credentialing, providing services to UCare members before being both contracted and credentialed can result in denied claims. Note: each practitioner within a practice will have his or her own credentialing approval date. These dates may vary across practitioners, even if they are part of the same practice.
The credentialing approval date with UCare cannot be backdated or changed from the date that is listed in the approval letter from UCare. Services provided to members prior to this approval date and the contract effective date can result in denied claims.
Providers who have opted-out or are not enrolled with Medicare, may not provide services to members enrolled in UCare Medicare Plans. Additionally, UCare follows CMS and MHCP eligibility and billing guidelines respectively, to determine service coverage. Providers eligible for Medicare coverage may choose to opt-out or not enroll in Medicare. However, for dually eligible members, UCare will not reimburse services covered by, but not billed to, Medicare because the provider has chosen not to enroll in Medicare. For additional information on opt-out providers, visit the Minnesota DHS Provider Manual to review Medicare and other insurance requirements.
When a member has other insurance primary to UCare, it is the provider’s responsibility to bill all third-party liability (TPL) payers and receive payment to the fullest extent possible before billing UCare.
When a member has other insurance primary to UCare, it is the provider’s responsibility to bill all third-party liability (TPL) payers and receive payment to the fullest extent possible before billing UCare.