Ir al contenido principal

Inpatient Readmission Policy Update

WellCare has updated its policy for inpatient readmissions. We made this policy publicly available on our website. Please share this notice with other members of your practice and office staff.

What does this mean for providers?

Beginning March 4, 2019, our clinical teams will use the Inpatient Readmission Policy to ensure readmission services occur when a patient is discharged/transferred from an acute care Prospective Payment System (PPS) hospital, and is readmitted to the same acute care PPS hospital, or hospital within the same network, within 30 days for symptoms related to, or for evaluation and management of, the prior stay’s medical condition. If the readmission to the same hospital occurs on the same day of discharge, that hospital shall adjust the original claim generated for the original stay by combining the original and subsequent stay into a single claim.

The readmission policy has been updated to include prepay procedures to align with our existing post-pay policy. 

This is not a new policy. The WellCare Medicare Advantage Provider Manuals address inpatient readmission guidelines. WellCare is executing readmission criteria published by federal and state agencies. 





Ícono de contacto

¿Necesita ayuda? Puede contar con nosotros.

Contáctenos
Última actualización: 2/7/2019
On April 22, 2024, UnitedHealth Group issued a press release, providing an update on the Change Healthcare cybersecurity incident that occurred on Feb. 21, 2024. Given the size of the data impacted, the investigation to determine whose data is impacted is expected to take several months. UnitedHealth Group believes this situation will impact “a substantial proportion of people in America” and is offering immediate credit monitoring and identity protection services, as well as a dedicated contact center to address questions. Visit Change Healthcare Cyberattack Support and/or reach out to the contact center at 1-866-262-5342 regarding any questions.

×