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Claims Updates
Please refer to the links below to access important WellCare claims guides and updates.
 
  • Reimbursement Policies
    From time to time, WellCare Health Plans, Inc. (the Plan), 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.

    Click the link below to access our current reimbursement policies.


    Current WellCare Reimbursement Policies

 
  • Claims/Encounter Companion Guides
    Institutional Claims / Encounter Guide
    Professional Claims / Encounter Guide 
    Dental Claims / Encounter Guide
    Outbound Benefit Enrollment Companion Guide
     
  • HIPAA Adjustment Reason Code Changes
     
  • Explanation of Payment Enhancements
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