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Procentive Knowledge Hub

UCare Choices Payer Name and ID Change on 1.1.2019

Overview  

As of January 1, 2019, UCare will rename their UCare Choices and Fairview UCare Choices plans to be UCare Family and Individual. This new plan will have a separate payer ID from other UCare plans. Complete the steps outlined in this article before January 1, 2019 to ensure that you do not experience interruptions in billing claims for clients who are currently on the UCare Choices or Fairview UCare Choices plan.

 

You'll want to complete the steps outlined below before January 1, 2019. Procentive has already added the new payer UCare Family and Individual to our list of available payers and will automatically update the payer ID on January 1, 2019.

Confirm UCare Clients' Plan 

UCare offers many different plans, including UCare Choices and Fairview UCare Choices. As a first step, please confirm which of your UCare clients currently have the UCare Choices or Fairview UCare Choices plan. The upcoming change only impacts these clients.

Step 1: Run Report 3070 in the Reports Module to see a list of all UCare clients (if you have more than one UCare payer, make sure you include all of them in your report).

Step 2: If you are unsure which of these clients have UCare Choices or Fairview UCare Choices, please call UCare to confirm.

 

Add UCare Family and Individual to the Payers Module

If you have clients that are on UCare Choices or Fairview UCare Choices, you'll want to add the new payer UCare Family and Individual to your Payers Module, so you can be prepared for the switchover.

Step 1: Add the new payer UCare Family and Individual (ID: 52629) to the Payers Module.  

  • The UCare Family and Individual payer ID will be the same as the existing UCare payer ID.  
  • We will automatically update the payer ID for UCare Family and Individual on 1/1/2019.

Step 2: Copy over current codes and rates and other pertinent settings (eg. Payer Rules tab) to UCare Family and Individual.

 

Add UCare Family and Individual to the Necessary Clients

Once you have confirmed which clients need to be updated, update their Clients Module > Payers tab accordingly:

  • Keep the existing UCare payer.
  • Add the new payer UCare Family and Individual.

Your clients will need both of these payers in their record during the transition as you will submit claims to one or the other based on Date of Service.

Step 1: Go to the Client Profile > Payers tab.

Step 2: Locate the existing UCare payer > Eligibility Dates tab.

Step 3: Enter a To Date of 12/31/2018.

Step 4: Add the new UCare Family and Individual payer to the client.

Step 5: Go to Eligibility Dates tab in the new payer and enter a From Date of 1/1/2019.

Step 6: Click Save.

According to these eligibility rules that you set up, any claim on or before 12/31/2018 will use the older UCare payer ID.  Any claim on or after 1/1/2019 will use the new UCare Family and Individual payer ID.

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