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Payment Policy

This notice is to clarify a segment of WellCare's payment policy language applicable to all WellCare Medicaid markets. WellCare's payment policies are based on publicly distributed guidelines from established industry sources such as the Centers for Medicare and Medicaid Services (CMS), the American Medical Association (AMA), state health care agencies and medical specialty professional societies.

If you have questions about this information, please contact your Provider Relations representative.

Policy Description Claim Type
Claims and Payment Policy Intensity Modulated Radiation Therapy (IMRT)  Facility and Professional 
Claims and Payment Policy
Emergency Department Radiology Utilization  Facility and Professional
Claims and Payment Policy
Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing Lab 
Claims and Payment Policy
Inpatient Notification

Facility 

Claims and Payment Policy
Pre-Payment and Post-Payment Review  Facility and Professional
Claims and Payment Policy
Same Day Emergency Department Visits Facility 
Claims and Payment Policy
Screening for Colorectal Cancer Using Cologuard – A Multitarget Stool DNA Test  Facility and Professional 

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Last Updated On: 11/25/2019