New User Registration for Online provider claim reconsideration form

  • It is necessary to create an account to access and submit the Online Provider Claim Reconsideration Form. After creating an account, you can return at any time and submit new forms by logging in.
  • Please Note If you create an account and then get a UCare Provider Portal account, you may disregard this account and begin using the Provider Portal to submit the online form.
  • Terms & Conditions

    By submitting the form below, you validate that all the above information is accurate. You also agree to the Provider Portal User Agreement

    User Agreement

    UCare is a nonprofit corporation which is licensed as a health plan by the State of Minnesota and which has entered into agreements with providers to arrange for the delivery of health care services to eligible individuals ("UCare Members"). UCare has established this web site ("Site"), where a provider may electronically obtain access to fill out and submit forms online.

    As an authorized user of this Site ("Provider"), you the Provider agree that your access and use of this Site are subject to the following terms and conditions.

    Access to the Site

    The Provider shall create a unique user identifier (the "Username") and password (the "Password") for electronic access to the Site which shall permit Provider to fill out and submit a form online. Access to this online form shall be conditioned upon Provider's entry of the Password, User ID, and any other information required by UCare.

    Password Confidentiality

    Provider will treat as confidential and take all necessary steps to maintain the confidentiality of the Password and User ID, and will permit only its authorized employees and agents to have access to the Password and User ID. Only authorized employees and agents who need to use the Site for the performance of their job shall have access to the Password and User ID. Such authorized employees and agents shall sign a confidentiality agreement describing appropriate use consistent with this Agreement as a condition of accessing the Password and User ID. Provider will notify UCare immediately if Provider believes confidentiality of the Password or User ID has been compromised or if an employee or agent with access to the Password or User ID leaves Provider's employment or agency, and UCare may, in its discretion, deactivate Provider's current Password and User ID and issue a new Password and User ID to Provider. At UCare's request, Provider shall provide UCare a list of persons who have access to the Password and User ID and a description of the safeguards used to ensure appropriate access.

    Use and Ownership of Information Provider acknowledges that the Site and all information retrieved through the Site is proprietary information of UCare and shall be and remain the exclusive property of UCare. Other than pursuant to the terms of this paragraph, Provider shall not appropriate or use any information retrieved through the Site without UCare's prior written consent. Provider acknowledges that any reliance on information contained at this Site is at the Provider's risk.

    Use of Site Provider shall not use the Site for communication to UCare of information in any urgent or emergency situation. Provider will not knowingly introduce a virus-bearing document into the Site. Provider will notify UCare if Provider believes a virus has been introduced into the Site.

    Compliance with Laws Provider agrees to comply with all applicable laws relating to Provider's use of the Site. Provider understands that UCare and Provider shall be subject to the rules and regulations promulgated pursuant to the Health Insurance Portability and Accountability Act ("HIPAA"), including 45 C.F.R Parts 160 and 164 relating to Standards for Privacy of Individually Identifiable Health Information (the "Privacy Rules"). Provider shall cooperate with UCare to comply with the Privacy Rules, including execution of a business associate agreement if required, and agrees that UCare shall have the right to terminate Provider's access to the Site in the event that Provider fails to take all necessary actions for compliance with the Privacy Rules.

    Security This Site uses Secured Socket Layer (SSL) encryption to protect the privacy of data during transmission across the Internet. This Site supports 128-bit encryption strength. Although UCare has taken these reasonable security measures, UCare does not make any representations or warranties regarding the security of data exchanged to or from the Site over the Internet.

    Indemnification Provider shall assume sole responsibility for and shall defend, hold harmless and indemnify UCare for any and all claims, liabilities, damages, or judgments that may arise out of the acts of omissions, including any breach of this Agreement or any other unauthorized disclosure or use of any protected or confidential information retrieved from the Site, by Provider or its employees, agents or representatives. The provisions of this paragraph shall survive termination of this Agreement.

    Disclaimers and Exclusion of Liability UCare specifically disclaims to the fullest extent permitted by law any warranties, whether statutory, express or implied, regarding the Site, (including, where law permits, implied warranties of merchantability and fitness for a particular purpose). UCare shall not be liable for any losses, damages or claims of any nature whatsoever arising from Provider's use of the Site (even if that loss or damage was caused by the negligence of UCare or its agents).

    Amendments and Termination UCare may amend the terms of this Agreement at any time by posting revised terms and conditions on the Site. Revised terms and conditions will become effective 30 days after posting. By continuing to use the Site after that time, Provider agrees to abide by and be bound to the revised terms and conditions. UCare may terminate Provider's Password and access to the Site without notice at any time for any reason.

    Entire Agreement This Agreement and any additional terms posted by UCare on the Site constitute the parties' complete agreement on the matters specified in this Agreement, and supersede all prior representations or agreements with respect to such matters. No oral modification or waiver of any of the provisions of this Agreement shall be binding on either party.

    By registering for access to this website I acknowledge and agree to the following: