WellCare has completed a review of its mapping to HIPAA Claims adjustment reason codes to better align with recent updates. Please note that the Plan will continue to periodically publish changes to this list of codes to remain current with industry guidelines. The first of this update series of HIPAA Claims Adjustment Reason Codes for the Plan will become effective
December 1, 2008.
 

HIPAA Adjustment Reason Codes

Frequently Asked Questions

What do these code changes mean to me?

Because we will be sending updated HIPAA codes on the 835 remittance advice, you may need to update your billing systems depending on how they are programmed.

What are the nature of the changes?

CMS periodically updates its list of HIPAA Reason Codes, and we are progressively matching our list to theirs. We will continue to monitor and implement periodic changes made to the HIPAA codes by CMS in order to remain compliant.

Can I still submit paper claims?

Yes. However, we recommend submissions through the electronic claim process as it is more expedient.