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Authorizations

Hospitals and ancillary providers must get prior authorization before providing any medical services to Wellcare members, except for emergency services. If emergency services result in an inpatient hospital stay, hospitals must contact the member’s assigned IPA for authorization. The member’s assigned IPA can be found on the member’s Wellcare ID card.

 

Failing to get authorizations before providing services may result in payment delays and/or claims payment denials.

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Last Updated On: 6/2/2023
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