Medication Therapy Management (MTM) Provider Information
The University of Minnesota UPlan Medical Program (UPlan) invites pharmacists to join the UPlan/MedEdgeRx MTM Provider Network to provide medication therapy management services to eligible University employees and their dependents and to state employees and their eligible dependents participating in the State of Minnesota SEGIP (State Employee Group Insurance Plan) Advantage Value for Diabetes Benefit.
MTM providers are needed throughout the state of Minnesota.
Pharmacist Eligibility
Pharmacists are eligible to become MTM providers in the UPlan/MedEdgeRx network if they graduated during or after 1996, or have completed an approved continuing education course. Pharmacists must be licensed in their state of practice.
The American Pharmacists Association currently offers approved training:
APhA’s Delivering Medication Therapy Management Services
Application to Join the UPlan/MedEdgeRx MTM Provider Network
UPlan/MedEdgeRx MTM Provider Application (pdf)
In addition to completing the application, each pharmacist is required to submit:
- Copy of current state pharmacist license
- Copy of diploma
- Current resume/CV
Use the supplemental form for additional practice sites and return with the application.
Supplemental Application Form (pdf)
Information for Network Provider, UPlan
- The Complete UPlan MTM Benefit Program Design Statement (pdf)
- UPlan MTM Frequently Asked Questions (pdf)
- UPlan/MedEdgeRx MTM Policies and Procedures (Administrative Program) (pdf)
- General Instructions for Submitting MTM Claims (pdf)
- UPlan MTM Fee Structure (doc)
- UPlan MTM/SEGIP Program Comparison (pdf)
University of Minnesota UPlan MTM Program
UPlan Member Eligibility
UPlan members are eligible to participate in MTM services if they are (1) currently taking four or more UPlan-covered prescription and over-the-counter medications for chronic conditions or (2) referred by their physician or (3) have a diagnosis of diabetes, regardless of number of medications. A physician referral should be documented in the patient’s medical record.
UPlan Wellbeing Program
UPlan members who participate in the MTM program have the opportunity to earn wellbeing points in the UPlan's Wellbeing Program. These points can be used toward a reduction on annual medical rates.
UPlan Formulary
Prime Therapeutics LLC is the Pharmacy Benefit Manager for UPlan prescription claims. Pharmacists enrolled as providers in the UPlan MTM Network should consult the UPlan drug formulary when making recommendations for changes in a patient's medication therapy. The current University of Minnesota UPlan Formulary (pdf) lists the medications that are covered by the program.
State Employee Group Insurance Plan (SEGIP) Advantage Value for Diabetes Benefit
The UPlan/MedEdgeRx MTM network provides MTM services to the SEGIP Advantage Value for Diabetes Benefit. . SEGIP Advantage Plan members 18 years or older (whether active participant, dependent, early retiree, or former employee who has continued coverage (FEWD, COBRA), are eligible for the Advantage Value for Diabetes Benefit if they have been diagnosed with Type I or Type II Diabetes. Advantage High Deductible Health Plan members are not eligible.
Information for Network Provider, UPlan
- Advantage Value for Diabetes Benefit
- Frequently Asked Questions
- General Information for Billing SEGIP Diabetes MTM Claims (pdf)
- UPlan MTM/SEGIP Advantage Plan for Diabetes Program Comparison (pdf)
Program Contacts
Julie Balthazor
MTM Benefit Program Coordinator
balt0012@umn.edu
612-625-0001
Office location:
B288 Mayo Memorial Building
420 Delaware Street S.E.
Minneapolis, MN 55455
Mailing address:
7-159 WDH
308 Harvard Street S.E.
Minneapolis, MN 55455
Office of Human Resources
phone: 612-624-8647 or 800-756-2363
email: ohr@umn.edu