six ucare choices health plans debut on mnsure · care and well baby care, pediatric dental...
TRANSCRIPT
Six UCare Choices health plans debut on MNsure UCare will celebrate 30 years of service to Minnesotans in 2014. In fact, UCare was one of the first Minnesota health plans to work with state public programs. Today, we proudly serve more than 300,000 members – and we serve more people from diverse cultures than any other health plan in the state.
Our participation in the MNsure health care marketplace offers another path to provide quality health coverage to our state’s residents. We are proud to be among the first Minnesota health plans to offer affordable, comprehensive commercial coverage to individuals and families shopping on MNsure.org.
Our six UCare Choices plan levels are only available through MNsure. Offerings include UCare Choices Core or “catastrophic” coverage, UCare Choices Bronze, UCare Choices Silver, UCare Choices Gold, Fairview UCare Choices Bronze, and Fairview UCare Choices Silver. All of these plans include free preventive care for adults and children, free routine pre- and post-pregnancy care and well baby care, pediatric dental coverage, and more.
UCare Choices is offered in 23 counties in Minnesota with a variation of premiums and coverage. Fairview UCare Choices is offered in eight counties.
• Individuals or families who choose Fairview UCare Choices will have a lower monthly premium than other UCare Choices plans, and access to the Fairview Health Network of hospitals and clinics in the Greater Twin Cities area. This network includes the nationally ranked University of Minnesota Medical Center and its sought-after physicians and specialists, as well as its many independent clinics. • Individuals or families choosing UCare Choices will have access to a wider network of providers and leading organizations as Fairview Health Network, North Memorial, HealthEast, Park Nicollet, and many others. A general overview of benefits for our six plans is here.
Winter 2014
UCare’s Mobile Dental Clinic is visiting these counties this winter:•Chippewa County –
Montevideo, Dec. 2-6, 2013•Mower County –
Austin, Jan. 6-10, 2014•Kandiyohi County –
Willmar, Feb. 10-14, 2014
Visit the Dental Care for U page on our website for more dates.
PCNLsIf you need to adjust your order for number of PCNLs, email Monica Hart, UCare State Public Programs, at [email protected].
TransportationA reminder that all transportation arrangements for UCare members (click here for eligibility) are made through calling Health Ride (number at back of newsletter).
Did you know?
Visit
UCare’s Counties web page
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County Hotline: 1-866-457-7146 toll free
Providing helpful information is important to us! Learn more by visiting our UCare Choices website or contacting UCare Choices sales representatives Carla Foster or Nettie Pegors at 612-676-6606. UCare’s friendly and knowledgeable UCare Choices Customer Services representatives can be reached at 612-676-6600.
New staff joins UCare Health PromotionMatt Holida (pron. “holiday”) is UCare’s new Health Educator in our Health Promotion area. Matt coordinates our SEATS (Seats, Education, and Travel Safety) program, UCare’s Mobile Dental Clinic, and the Community Education classes reimbursement activity.
Matt formerly was a Health Educator with Isanti County Public Health. As such, he worked with alcohol, tobacco and other drug (ATOD) abuse prevention, the Statewide Health Improvement Program (SHIP), SEATS, and other programs. He looks forward to working with county agencies, and can be reached at [email protected] or 612-676-3583.
County TeamOur Government Relations County Team recently welcomed Laurie Ann Moore as UCare’s County Relations Supervisor. Before joining UCare, Laurie worked for almost eight years in the Disability Services Division at the Department of Human
Services (DHS) as the Disability Response Policy Lead. She also has been the Developmental Disability (DD) Supervisor for Wright County.
Laurie is a licensed social worker and is passionate about person-centered service coordination with all providers. She is thrilled to build on our collaboration with UCare’s county partners to achieve positive health outcomes for the Minnesotans we serve.
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2014 member ID card change: PCP will no longer be printed on ID cardsUCare will no longer print a member’s primary care provider (PCP) on member identification (ID) cards for coverage effective Jan, 1, 2014. This ID card element has indicated the PCP or primary care clinic to which a member is assigned within UCare’s system.
UCare made this ID card change to minimize member confusion and reduce costs associated with reissuing ID cards.
Here’s some background on this decision. When a new member selects a PCP during the enrollment process, the member is linked to the PCP’s clinic within UCare’s data. However, many members do not select a PCP. When this is the case, UCare assigns a clinic that is located near the member’s home address. Too often, however, this auto-assignment process selects a clinic the member is not using for care, and this causes confusion. Despite members’ ability to receive care from any network provider without a referral, many members were concerned they could not go to any other clinic than the one printed on their ID card.
The decision to remove the PCP field from member ID cards does not change the value UCare places on primary care. UCare continues to encourage all members to have a primary care physician they see routinely.
PMAP/MinnesotaCare expansion newsThe following information is the result of the 27-county Department of Human Services PMAP/MinnesotaCare reprocurement RFP, and is effective Jan. 1, 2014. On that date, UCare is:• The only health plan in Aitkin, Cook, Kittson, Koochiching, Lake, Lake of the Woods, Marshall,
Matt Holida
Laurie Ann Moore
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Mahnomen, Mower, Norman, Pennington, Pine, Red Lake, Roseau, and Winona counties.• One of two health plans in Benton, Carlton, Chisago, Fillmore, Houston, Isanti, Mille Lacs, Olmsted, Polk, St. Louis, Sherburne, and Stearns counties.
UCare is preparing for this expansion in many ways. For example, we are:• Analyzing staff needs in Customer Service, Clinical Services, Claims, and Enrollment.• Working with delegates to ensure adequate access for new members.• Honoring authorizations from other health plans and permitting out-of-network providers as needed to ensure continuity of care.• Sending information about transitions and other updates by way of this newsletter, county check-in meetings, and special emails.
Please read a communication to county staff that describes UCare’s preparations in greater detail.
Behavioral Health updates• Behavioral Health staff is now onsite at UCare. This terrific change improves our ability to effectively coordinate member care between behavioral health and medical services at the health plan level. Want to know more? County social service and public health directors are welcome to call or arrange a meeting with Nancy Houlton, Behavioral Health Director, at 612-676-3311. Give her a call and talk about how this change may impact your community.• UCare recognizes the expertise counties bring to the determination of eligibility for Mental Health Targeted Case Management (MH-TCM) and Assertive Community Treatment (ACT) services. Effective Nov. 1, 2013, we accept the county determination of eligibility and no longer require notification or authorization of these services.
Behavioral Health conducted six trainings in October for providers on this new authorization process. You or others wishing to gain that information can access that training here.
• We have updated our system to reimburse for the telemedicine originating site fee (code Q3014) for non-MSA counties only. The effective date for this change is retroactive to Jan. 1, 2013; therefore, claims for any telemedicine services provided to UCare members in non-MSA counties for dates of service during this calendar year can be submitted.
SilverSneakers® program will be sole fitness partner The growing popularity of our SilverSneakers program and the lower participation in EnhanceFitness classes led UCare to discontinue offering EnhanceFitness classes in 2014. Because only UCare for Seniors, UCare’s MSHO, and UCare Connect members have coverage for SilverSneakers, we hope members will consider other available fitness options to maintain and improve their health. View our web page for more information about SilverSneakers and a list of participating locations.
Mammogram incentive updateDon’t forget, UCare is piloting an increased incentive for UCare’s MSHO members, ages 65-69, to get a mammogram. Eligible UCare’s MSHO members can receive a $100 gift card for completing their mammogram by the end of the year! This incentive will only be until Dec. 31, 2013, so please discuss this opportunity with your MSHO member today! You can view a copy of the gift card coupon on our website.
2013 UCare Fund grants announcedThis fall, UCare announced UCare Fund grants totaling $1,180,576: 29 community grants totaling $885,116 and four research grants totaling $295,460. The merit-based grants will be awarded to Minnesota organizations working to improve the health of people of all ages, cultures, and abilities in 2013. This news release has all the details.
Initiatives receiving UCare Fund support met four health improvement-related grant criteria for 2013: • Access to health care coverage• Disabilities• Healthy lifestyles• Medical home initiatives
These counties received 2013 UCare Fund grants for health initiatives:• Carlton County Public Health & Human Services, Cloquet – Funding for the “Building a Stronger Self ” program which provides health promotion, and chronic disease prevention and management education and support to developmentally disabled adults in Carlton County through classes and home visits.
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• City of Bloomington, Bloomington – Support for “Let’s Move! Child Care,” which seeks to increase the number of child care environments providing access to healthy food and beverages, encourage consumption of these foods, and provide opportunities for physical activity throughout the day.
• Dodge County Public Health, Dodge Center – Funding for an obesity reduction and prevention program offering community health interventions for children and adults.• Fillmore-Houston Community Health Service, Caledonia – Funding to reduce obesity among youth in Fillmore and Houston counties by working with area schools, child care providers, and early childhood facilities to increase nutrition and physical activity.• Koochiching County Health Department, International Falls – Funding for programming to prevent, reverse, or lessen the negative health outcomes due to chronic disease at all ages.
“UCare creates and maintains partnerships with community organizations to improve not only the health of our members in Minnesota but also the underserved in communities across our service area,” said Ghita Worcester, Senior Vice President of Public Affairs and Marketing, UCare. “We are proud to award UCare Fund grants in 2013 to so many public health, nonprofit, and community-based groups conducting innovative programs in the state.”
UCare Phone List
Behavioral Health ServicesNEW - Effective Nov. 1, 2013UCare Behavioral Health Services612-676-3300 or 1-888-531-1493 toll free
Sandy DelCastilloOperations Specialist, UCare612-294-5258
Clinical Services Authorization and Intake612-676-67051-877-447-4384 toll freeJessica Assefa Clinical Product Liaison 612-294-5057
Customer Services/ Enrollment612-676-3200 1-800-203-7225 toll free (State Public Programs)
612-676-6868 1-866-280-7202 toll free (SNP: UCare’s MSHO)
612-676-3395 1-877-903-0061 toll free(SNBC: UCare Connect)
Eligibility Verification 612-676-68241-800-203-7225 toll free
24/7 Nurse Line1-800-942-7858 toll freeTTY: 1-877-728-3311 toll free
Health Promotion612-676-3351 1-866-243-5157 toll free
Health Ride Transportation612-676-68301-800-864-2157 toll free
Provider Assistance Center (PAC)612-676-33001-888-531-1943 toll free
See-A-Dentist Appointment Hotline1-800-235-0564 toll free
Government Relations Carol Berg, RN, MPHPublic Health and County Manager612-676-3635 [email protected]
Sharon CrawfordCounty Relations [email protected]
Laurie Ann Moore, MSW, LGSWCounty Relations [email protected]
Do you have a question not answered through your regular contacts? Need help untangling an issue? Can’t remember who to call? Then use our toll-free County Hotline!
We welcome your calls and questions to help you work with our UCare members.County Hotline: 1-866-457-7146 toll free
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