Claims & Billing
Resources
Online Provider Claim Reconsideration Form (Use if you have a UCare Provider Portal account)
Online Provider Claim Reconsideration Form (Use if you do not have a UCare Provider Portal account)
Legacy Provider Claim Reconsideration Request Form (PDF, Fax: 612-884-2186)
Tips for Using the Online Claim Reconsideration Form
Advance Recipient Notice of Non-covered Service/Item (DHS)
Claim Attachment Cover Sheet (Fax: 612-884-2261)
The Electronic Funds Transfer (EFT)/Electronic Remittance Advice (ERA) form is now available on the Provider Portal.
New Provider Portal: Once logged in, click "Resource Center," the Document Center will open. From there, select the "Resources" tab and open the "Provider Payment and Remittance Request Form" accordion.
Fraud, Waste and Abuse
Waiver of Liability for Non-Contracted Providers
Resources for Electronic Transactions
UCare's New Claim System Information
Stroke and Heart Attack Diagnosis Codes that Reject when Billed with POS 11
UCare offers Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). If you would like to begin receiving funds and remits electronically, please complete the Provider Payment and Remittance Request Form within the UCare Provider Portal. If you have questions about EFT or ERA transactions, please email EFT835@ucare.org.
The standard Claims Payable Calendar displays the dates providers can expect remittance payment. Providers will receive notifications of additional temporary claim payment dates via Health Lines or Provider Bulletins.
An Explanation of Payment (EOP) provides information regarding the adjudication of your claims. Provider Guide: The Explanation of Payment (EOP) shows how to read your EOP and identify the differences for a paid or denied claim.
UCare requires the corresponding taxonomy to be submitted whenever a National Provider Identification (NPI) is reported on a claim submitted directly to UCare or on claims that will crossover and be coordinated with UCare coverage. When taxonomy is not reported on a claim that includes a NPI number(s), the claim will be rejected.
- For professional claims (submitted via 837P or CMS 1500) – billing and rendering taxonomy.
- For institutional/facility claims– billing (submitted via 837I or UB04) and attending taxonomy (submitted via 837I).
Common Billing Providers That Do Not Require Rendering Provider NPI or Taxonomy
Visit the Non-Contracted Provider Resources webpage for more information.
- If you contract with a third party to call UCare on your behalf, we need a signed acknowledgement form on file giving UCare permission to release information. Click the link below to approve a third party.
Provider Notification/Change/Update/Termination Third-Party Agreement Notification form
Resources are available to assist providers with online administrative functions. To simplify and streamline transactions, UCare supports a variety of electronic data interchanges (EDI).