UniCare Logo
UniCare 30 Years GIC Logo
  • Quick Links
  • Recent Spotlights
  • PC2 Program Resources
  • Plan Options

Changes to specialist tiering
For the plan year starting July 1, 2019, UniCare will move from individual to group tiering for specialists. This means all specialists within a practice will receive the same tier placement.
Learn more.

Webinar on how to submit behavioral health claims
Listen to our recorded webinar for tips on how to help avoid delays in the processing of your claims that may apply to your submissions.
Learn more.

Express Scripts site of care specialty pharmacy drug list effective April 1, 2019
View the list of specialty drugs that require review and dispensing by Express Scripts for non-Medicare members only. Check back for quarterly updates.
Learn more

Important Information about UniCare’s utilization management process
Our UM decisions are based on the appropriateness of care and service needed, as well as the member’s plan coverage.
Learn more

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.
Learn more

Availity remittance inquiry search option streamlined
We’ve changed the Check/EFT search option to make it easier for you to find your remittances.
Learn more

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.
Learn more

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.



Previous provider spotlights

Expansion of specialty pharmacy prior authorization list
Effective for dates of service on and after May 1, 2019, certain specialty pharmacy codes from new clinical criteria or current clinical guidelines will be included in our pre-service review process.
Learn more

Clinical criteria updates for specialty pharmacy
Effective for dates of service on and after March 1, 2019, new clinical criteria will be included in our clinical criteria review process.
Learn more

Resources for behavioral health providers
Get information about preapproval notifications, claims filing and processing, credentialing, and more.
Learn more

Updates to AIM guidelines for cardiac imaging
Beginning with dates of service on or after January 28, 2019, AIM Specialty Health® is revising its guidelines for certain cardiac imaging procedures.
Learn more

New EDI gateway for submitting claims directly to UniCare
Availity is now UniCare’s designated EDI gateway for both medical and behavioral health claims. Register on Availity today.
Learn more

Quality Centers and Designated Hospitals for Transplants
Our program offers quality, cost-effective services to eligible non-Medicare members. Get details about the program and check our listings of participating providers.
Learn more

HCAS provider enrollment form
Use this form to apply for credentialing to become a UniCare contracted provider.
Learn more

Standardized provider information change form
Use a standardized provider information change form to let UniCare know about changes to your practice.
Learn more

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.
Learn more

Welcome Packet
Check out our tools and resources to help your practice get started on your practice transformation journey.
Learn more

Provider Toolkit
Get in-depth information on each of the 10 Patient-Centered Primary Care program milestones, which are based on industry best practices.
Learn more

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.
Learn more

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.
Learn more


About UniCare
| Legal | Site Map | Contact Us


For self-funded plans, claims are administered by UniCare Life & Health Insurance Company. © 2000-2019 UniCare.