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Claims

WellCare wants to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements.

Reimbursement Policies

From time to time, WellCare Health Plans reviews its reimbursement policies to maintain close alignment with industry standards and coding updates released by health care industry sources like the Centers for Medicare and Medicaid Services (CMS), and nationally recognized health and medical societies.

Institutional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837I EDI transactions.

Professional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Enrollment Companion

Explains how to receive, load and send 834 EDI files for member information.


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Last Updated On: 2/3/2020
Medicare 가입자: Medicare 사기로부터 자신을 보호하고 도난을 식별하십시오! 미국 보건복지부(Department of Health and Human Services) 감사관실(Office of Inspector General)은 유전자 검사와 관련된 사기 수법에 대해 대중에게 경고하고 있습니다. 자신을 보호하는 방법을 알아보십시오.
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