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COVID-19 Information For Providers

Authorizations

All information contained on this page is applicable only during the declared pandemic time period or other time frames specified below. In the event of any conflict or inconsistency between the information contained on this page and the contents of the UCare Provider Manual, the information on this page shall control during the identified time frame.

PAGE LAST UPDATED OCTOBER 25, 2021

Recent Changes The Weeks of October 18 and October 25:

  •  October 25, 2021 – The end date for the waiving of authorization for post-acute services was extended from October 31, 2021, to January 31, 2022.

Waiving of Prior Authorization Requirements

UCare is temporarily changing prior authorization and notification requirements for certain post-acute care services effective for dates of service April 20, 2020, to January 31, 2022, in response to the Coronavirus (COVID-19) state of emergency. These changes will help to meet the needs of our members who may require post-acute care in the following settings:

  • Skilled Nursing Facility & Swing Bed
  • Long-Term Acute Care Hospital
  • Acute Inpatient Rehabilitation
  • Home Care Services (i.e., skilled nurse, home health aide)

Providers should continue to use UCare’s prior authorization form for notification as indicated in the chart. Notifications do not require the attachment of medical notes.

**UCare will continue to require prior authorization for out of network services.**

Post-Acute Care Setting UCare Plans

UCare Notification and Authorization Temporary Requirements

Effective for dates of service 4/20/20 to 1/31/22

Skilled Nursing Facility & Swing Bed Admission UCare Medicare

EssentiaCare

UCare Medicare with M Health Fairview and North Memorial

MSHO

UCare Connect + Medicare
Notification to UCare within 48 hours of admission.

UCare will continue to complete Concurrent Review.

https://media.ucare.org/-/media/documents/provider/general/nh_swingbed_admissionform.pdf

https://edocs.dhs.state.mn.us/lfserver/Public/DHS-4461-ENG
Long-Term Acute Care Hospital All Plans Notification to UCare within 48 hours of admission.

UCare will continue to complete Concurrent Review.

https://media.ucare.org/-/media/documents/provider/general/paform_general_u7634.pdf
Acute Inpatient Rehab All Plans Notification to UCare within 48 hours of admission.

UCare will continue to complete Concurrent Review.

https://media.ucare.org/-/media/documents/provider/general/paform_general_u7634.pdf
Home Health Care

(Skilled nurse visits, Home Health Aide)
UCare Connect

UCare Connect + Medicare
Notification to UCare within 48 hours of admission to home care services.

https://media.ucare.org/-/media/documents/provider/general/universal_home_health_pa_form.pdf

For all other services, UCare will continue to use its current prior authorization guidelines. Please refer to UCare’s authorization grids for these requirements.

Previously Approved Prior Authorizations for Elective Procedures and Services

In light of many non-essential health care services being postponed due to the Covid-19 outbreak, UCare is proactively extending prior authorizations for approved elective surgeries that were requested between Jan. 1, 2020, and March 31, 2020. We sent new letters with approved prior authorization extension dates of Dec. 31, 2020, for elective surgeries only. If you did not received a letter by June 1, 2020, please contact the Clinical Services Department via phone at 612-676-6705 / 1-877-447-4384 or fax to 612-884-2499 / 1-866-610-7215.

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