Working with UCare
Quick Reference Guide
New providers and long-standing partners may use this guide to effectively work with UCare and to navigate the information available on the provider section of the UCare website. The following is a high-level overview of key administrative procedures. Providers can bookmark this page for quick access.
UCare’s provider homepage is the starting point for health care professionals looking for valuable tools and resources as they provide care to UCare members.
At the top of the entire website you’ll find six category tabs - home, join our network, authorization, policies & resources, care managers and provider news. Additionally, at the top right corner of the page, you can access the provider portal via the “Log in” button.
Access the Authorizations page from the top navigation bar.
Search this section of the provider website for authorization requirements and forms by plan. Information is available for:
- Mental health and substance use disorder
- Medical injectable drugs
Providers can also view the following within the Resources & Information section:
- Authorization and notification grids
- Care or case management referral forms
- Delegates who work with UCare
- Medical Necessity Criteria
- Pharmacy and drug coverage information
- Restricted Recipient Program
- Universal referral form
- UCare product or benefit information
For specific plans, select the appropriate drop down.
Access the Care Management page from the top navigation bar.
Care Managers can find the following:
- Various resources and references including care management assignments by county or care system
- Policies and manuals
- Current and past training schedules and resources
- Care Manager referral form and more
For specific plans, select the appropriate drop down.
Access these resources and more within the Cultural Support Resources section of the Policies & Resources page from the top navigation bar.
UCare actively supports and promotes behaviors, attitudes and policies that enable providers to deliver services in ways that meet the needs of consumers from diverse cultures. The following resources may be of assistance to providers:
Providers should confirm member eligibility prior to treatment of a UCare member. Member Eligibility Lookup (log-in required) is available in the UCare Provider Portal.
For alternative verification options, visit the Verification of Eligibility section in the Member Enrollment and Eligibility chapter of the UCare Provider Manual.
On this page you will find:
- How to submit claims for payment
- What to expect after submitting claims to UCare
- Authorization resources and information
- Request access to the UCare Provider Portal
- Pharmacy resources
- UCare policies
- Managing locations and practitioners with UCare
- Additional resources, information and external links
Access the Policies & Resources page from the top navigation bar.
The Policies & Resources page contains important policies and resources available to help providers work with UCare members. Providers can self-serve to find the following information:
- Administrative resources
- Clinical support resources
- Helping our members
- Mental Health and Substance Use Disorder resources
- Non-Contracted provider resources
- Provider manual
- Training and education
Contact the Provider Assistance Center (PAC) at 612-676-3300 or 1-888-531-1493 toll-free, Monday through Friday from 8 am-5 pm, or send a secure message through the UCare Provider Portal (this is the preferred method of contact for complex inquiries).
PAC is a resource for providers. They help callers with the following:
- Claim status
- Eligibility questions
- Benefit information
- Prior authorization inquires
- Credentialing and/or contracting
- Other questions about working with UCare members
Access this page within the Provider Manual drawer on the Policies & Resources page.
UCare’s Provider Manual is an extension of your contractual obligations. Bookmark the UCare Provider Manual page to ensure you have access to the most up-to-date information and reference material.
Please review the Provider Manual regularly, it is updated quarterly. When reviewing the document, reference the table of changes to see the most recent revisions.
TIP: To search for a key word, select ctrl + F.
Access the Provider News page from the top navigation bar.
Provider bulletins and monthly provider newsletters are the primary way we communicate important information to our provider network. We recommend providers sign-up to receive these emailed communications.
If you already receive communication from UCare but would like to adjust your subscription, visit the Provider News page, select “Sign Up” under the “Newsletters & Alerts” section and complete the web form.
The Provider News library is a searchable archive of news.
Access the UCare Provider Portal from the UCare provider website (ucare.org/providers), select “Log in” in the upper right-hand corner of the page.
The portal requires registration and a password. Contact your portal administrator to create or modify a user account. Call the Provider Assistance Center (PAC) with questions at 612-676-3300 or 1-888-531-1493 toll-free, Monday through Friday from 8 am-5 pm.
The UCare Provider Portal is a secure website that allows your organization to access information needed to work with UCare members. Providers use the portal to:
- Check member eligibility
- See a member’s copays and benefits
- Lookup authorizations
- Check claim status
- View Remittance Advice
- Send a secure message to PAC
Non-Contracted providers: visit the UCare Non-Contracted Provider Resources page for information about how to request access to the portal.