Manage Your Information
All UCare Network Providers must be enrolled with the state (Minnesota Department of Human Services, DHS) as Minnesota Health Care Programs (MHCP) providers. Network providers must comply with the provider disclosure, screening and enrollment requirements in 42 CFR §455. [Minnesota Statutes, §256B.69, subd. 37; and 42 CFR §438.602(b)]
Ensure that UCare has accurate information for your organization, location and service providers.
This online tool allows UCare contracted providers to view information on file with UCare and make changes if needed.
Please note, individual provider demographic changes must be communicated to the Minnesota Department of Human Services (DHS) before they can be implemented by UCare. Please ensure DHS processes are complete prior to submitting your request.
Examples of the changes that can be made are:
- Update location demographics (i.e., phone number, accepting new patients, office hours, languages, etc.).
- Add an existing UCare credentialed practitioner or selected non-credentialed practitioner* to an additional practice location.
- Remove a practitioner from a practice location.
Please Note: This application cannot be used for adding new locations or facility/location changes, new practitioners, non-credentialed practitioners except as noted*. Use the proper form in the drawers below to make these types of changes.
*Non‐credentialed provider specialties: Audiologists, Certified Registered Nurse Anesthetist (CRNA), Nutrition, Occupational Therapists, Physical Therapists, Speech Therapists, Anesthesiology, Hospital‐based Practitioners (not including Hospital‐based Psychiatrists or Hospitalists) and Radiologists.
Login | User Guide
MN Uniform Practitioner Change Form for non-online use.
Submit to: credentialinginfo@ucare.org or Fax: 612-884-2184
Please note, individual provider demographic changes must be communicated to the Minnesota Department of Human Services (DHS) before they can be implemented by UCare. Please ensure DHS processes are complete prior to submitting your request.
See providers who do not require credentialing.
Add a non-credentialed practitioner | Instructions
Change a non-credentialed practitioner | Instructions
Term a non-credentialed practitioner | Instructions
Incomplete forms will be returned without processing. Please allow 60 calendar days for your request to be completed. You will receive a letter notifying you of completion. For status checks, please contact UCare's Provider Assistance Center at 612-676-3300 or toll free at 1-888-531-1493.
Please note, individual provider demographic changes must be communicated to the Minnesota Department of Human Services (DHS) before they can be implemented by UCare. Please ensure DHS processes are complete prior to submitting your request.
Incomplete forms will be returned without processing. Please allow 60 calendar days for your request to be completed. You will receive a letter notifying you of completion. For status checks, please contact UCare's Provider Assistance Center at 612-676-3300 or toll free at 1-888-531-1493.
Personal Care Attendant
Personal Care Attendant (PCA) Form Instructions
PCA UMPI Add Form
PCA UMPI Change Form
PCA UMPI Term Form
Elderly Waiver
To be added in our system for claims processing, you will need to complete the Add a facility or location form | Instructions
To update your information, complete the appropriate form below:
Change or update your facility tax ID, legal name, address, NPI/UMPI | Instructions
Remove an organization or close a location | Instructions
Interpreter
Interpreter - Add, change, remove
Transportation
NovusMED User- Add, Remove, Change
NovusMED IP Address- Add, Remove
Facility Add Form - Add a facility or location | Instructions
Please note, new locations must be enrolled with the Minnesota Department of Human Services (DHS) before they can be added to your contract with UCare. Please ensure DHS enrollment is complete prior to submitting your request.
Facility Change Form - Change or update your facility profile (tax ID, legal name, ownership, address, phone, NPI) | Instructions
Please note, site level demographic changes must be communicated to the Minnesota Department of Human Services (DHS) before they can be implemented by UCare. Please ensure DHS processes are complete prior to submitting your request.
Disclosure of Ownership (DOO) Form (Complete this form If your update is a result of change of ownership)
Facility Close Form - Remove an organization or close a location | Instructions
Note: Once the new location has been established in UCare's system, complete the "Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Authorization Agreement to request set-up for the new site. This form can be accessed through your UCare Provider Portal account.
This form is for UCare Advocate plan partners to add, update or remove participating facilities to their network.
If you contract with a third-party biller to call on your behalf to UCare, we need a signed acknowledgement form on file giving UCare permission to release information. Please use the following form to provide this information.
Provider Notification/Change/Update/Termination Third-Party Agreement
Portico data set-up (Portico staff only)
Incomplete forms will be returned without processing. Please allow 60 calendar days for your request to be completed. For status checks, please contact UCare's Provider Assistance Center at 612-676-3300 or toll free at 1-888-531-1493.