News & Alerts
Provider News Library
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.
Updated Prior Authorization Criteria for Drugs on the IFP Formulary
Starting July 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.
Additional Claims Payment Run Has Ended
UCare has ended the temporary third claims payment run on Tuesdays and has returned to its standard Wednesday and Friday payment runs.
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.
May 2022 Health Lines
Learn about the following: Q2 2022 Provider Manual Update, Working with UCare, Mental Health Workforce, Minnesota's Community Resource Hubs and more.
UCare Provider Manual Updated for Q2 2022UCare’s 2022 Provider Manual contains critical information that providers need to know to effectively work with UCare and our members. It is important that providers reference the online manual regularly for up-to-date content. The Provider Manual has been updated to reflect current business practices.
Go to the Provider Manual.
Some 277CA Files to be Re-Transmitted
UCare recently identified some 2022 claims were not listed on 277CA (claims acknowledgement) files transmitted for 837 claim submissions.
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.