Changes to preapproval requirements
Effective January 1, 2018, there will be changes to UniCare’s list of preapproval requirements for non-Medicare members only.
New preapproval requirement for hyaluronic acid injections to the knee
Starting January 1, 2018, UniCare will require preapproval review for hyaluronic acid injections to the knee. (for non-Medicare members only)
Updates to medical policies
Check for policy changes effective March 1, 2018.
Enhanced post-service review process
UniCare expanded its post-service review processes on April 1, 2017 to ensure that claims are in compliance. Providers who submit addition documentation after the initial claim submission should mail it to Orthonet at the address provider in Orthonet's letter.
Availity remittance inquiry search option streamlined
We’ve changed the Check/EFT search option to make it easier for you to find your remittances.
CVS Caremark specialty drugs requiring notification effective April 1, 2018
View the list of specialty drugs that require review and dispensing by CVS Caremark for non-Medicare members only. Check back for quarterly updates.
New PCP reimbursement for certain behavioral health services
UniCare will now reimburse PCPs for tobacco, alcohol and substance use screenings, and ambulatory detoxification. See the list of covered codes for these services.
Availity has replaced AccessPoint – register on Availity today!
AccessPoint was retired on December 8, 2017. The Availity Portal is your exclusive web portal for access to all electronic tools and resources previously on the secure AccessPoint portal. Register with Availity now. (If you already use Availity, no additional registration is needed.)
HCAS provider enrollment form
Use this form to apply for credentialing to become a UniCare contracted provider.
Standardized provider information change form
Use a standardized provider information change form to let UniCare know about changes to your practice.
Expanded review will be required for certain infused specialty drugs
Effective October 1, 2016, if a non-Medicare member will be getting infusions of certain non-oncology specialty drugs in a hospital outpatient setting, an expanded review will be conducted to review for both the drug for clinical appropriateness and the level of care.
Send discharge summary for inpatient claims
Rather than send us the entire medical record for an inpatient claim, you can just send the discharge summary. We’ll contact you if we need more information.
Patient-Centered Primary Care Program (PC2)
Learn about our innovative program to promote coordinated, evidence-based care aimed at improving quality, patient experience and affordability.
Check out our tools and resources to help your practice get started on your practice transformation journey.
Get in-depth information on each of the 10 Patient-Centered Primary Care program milestones, which are based on industry best practices.
Collaborative Learning Opportunities
These webinars offer our practices access to the most current information from the country’s leading health care experts … all in support of practice transformation and fulfilling Patient-Centered Primary Care program expectations.
Cost and Quality Resources
A directory of resources to help primary care practices committed to delivering high-quality, patient-centered care that is also efficient.