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New Century Health Cardiology Prior Authorization Program

September 20, 2023

Wellcare has partnered with New Century Health (NCH) to implement a new cardiology prior authorization program, the Cardiology Management Program. This program is intended to help providers easily and effectively deliver quality patient care.

Effective July 1, 2023, cardiology services rendered in a physician's office, in an outpatient hospital ambulatory setting, or in an inpatient setting (planned professional services only) must be submitted to NCH for prior authorization. Approvals issued by Wellcare before July 1, 2023, are effective until the authorization end date, but all prior authorization requests needed after July 1, 2023, must be submitted to NCH. This requirement applies to all of your Medicare members ages 18 and older.

Prior authorization can be requested by:

NCH uses clinical criteria based on nationally recognized guidelines to promote evidence-based guidelines. When using NCH's web portal, you will be able to:

  • Obtain real-time approvals when selecting evidence-based NCH treatment care pathways.
  • Determine what clinical documentation is needed for medical necessity review.
  • View all submitted requests in one location.
  • Request to speak with a cardiologist to discuss treatment options.

Wellcare is proud to be your healthcare partner. If you frequently prescribe cardiology services and are new to this process, an NCH representative will contact you soon to schedule an introductory meeting and training. If you are new to NCH, portal login credentials will be securely emailed to you after your meeting and before July 1, 2023. If you need access to NCH's portal and have not received a call from NCH, or if you have any questions beforehand, please email providertraining@newcenturyhealth.com or call NCH at 1-888-999-7713, Option 6. You may also call Wellcare directly at 1-855-538-0454 or visit wellcare.com. Just choose your state from the drop-down menu and click on "Providers."

We look forward to working with you.

Sincerely,
Wellcare

 

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Last Updated On: 9/20/2023
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