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- Fill the forms out as instructed and use the UCare Contracting Checklist to ensure all documents are submitted.
- Missing and/or incomplete information may result in processing delays and/or closure of your request.
- Be sure to keep the files in the same format to prevent delays in processing your application.
- Please complete forms electronically (download form, type in answers and save). Handwritten forms will be returned.
1. Download the Contracting Request Forms
All Provider Types must complete the following forms:
UCare Contract Intake Form (XLS)
Site/Practitioner List (XLS)
Disclosure of Ownership Form (PDF)
Provider Directory & Subdirectory Questionnaire (PDF)
Certificate of Insurance (COI): You will need to contact your insurance carrier to obtain copies.
Additional Forms for Medicare Certified Providers:
FDR Attestation (PDF)
FDR Compliance Program Requirements (PDF)
Additional Forms for Mental Health Providers:
Behavioral Health Survey (XLS)
Additional Forms for Transportation Providers:
Current Vehicle Certification from MNDOT: You will need a copy of your current Vehicle Certification from Minnesota Department of Transportation (MNDOT).
2. Attach all required contracting request documents to an email and send to firstname.lastname@example.org.
3. For contracting request questions, please email email@example.com.
- In some cases, you must also be credentialed and approved. See Credentialing information.
- Before seeing UCare members, you must receive a contract effective date from UCare. Seeing UCare members prior to the contract effective date and the credentialing approval date (if applicable) will result in out-of-network claim processing, claim rejections or claim denials.
- Submitting a contracting request does not guarantee enrollment as a participating UCare provider.
- Once we have received all your documents for the contracting request, we will need up to 90 days to process the request.
- During this review, you should start the credentialing process, if credentialing is required.
- UCare's contracting department will reach out to you to initiate the contracting process if a decision is made to contract with your organization. UCare will notify you in writing if the decision is made to not contract with your organization.
- You will be notified via email when the full provider enrollment process is complete - contracting and credentialing (if needed) - and you can see members.
- UCare will notify you if we are denying your request. If your contract application is denied, you will receive a communication from UCare providing instructions for appealing this decision. All appeals must include new information that was not contained within the initial request, along with detailed documentation outlining why UCare should reconsider its determination.
Frequently Asked Questions
If you are having difficulty downloading contracting forms, please send an email to firstname.lastname@example.org with the subject "Having Difficulty Downloading Forms."
UCare requires all contracted providers with assigned National Provider Identifier (NPI) or Unique Minnesota Provider Identifier (UMPI) to be registered with the Minnesota Department of Human Services. Information regarding registration can be found on the MHCP Enrolled Providers page, under “MHCP Provider Requirements.”
If you have questions on the registration process or other questions for DHS, please call the DHS Information Desk at 651-431-2000.
You may not begin seeing members until the contract effective date. The contract effective date will generally be determined by UCare once the signed contract is received from the provider. Providing services to UCare members before you are contracted can result in denied claims.
For providers who also require credentialing, providing services to UCare members before you are both contracted and credentialed can result in denied claims. Please note that each practitioner within your practice will have his/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, please visit the MN Department of Human Services 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.