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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.

Reference Guides


Contains key phone numbers and information on claims, appeals, & more.


Ícono de contacto

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Last Updated On: 11/1/2024
El 21 de febrero de 2024, Change Healthcare registró un incidente de ciberseguridad. Cualquier persona afectada por este incidente recibirá una carta por correo. Puede obtener más información directamente de Change Healthcare o mediante el centro de atención al cliente llamando al 1-866-262-5342. ×