Medicare
- Reminder of CMS Lab Ordering Guidelines
- D-SNP Patients Must Verify Medicaid Eligibility Annually
- New Century Health Oncology Prior Authorization List: Effective April 1, 2023
- Wellcare 2023 $0 Immunizations Part D Vaccines - (PDF)
- Special Needs Plan Model of Care Self-Study Program
- Medicare Part B Drugs List: Effective January 1, 2023 (Appendix A)
- Medicare Prior Authorization Change Summary: Effective January 1, 2023
- Special Supplemental Benefits for the Chronically Ill Attestation: Process Change
- CMS Lab Ordering Guidelines Reminder
- Sneak Preview of 2023 Improvements
- New Cardiac Surgical Quality and Safety Management Program with TurningPoint
- Medicare Provider CMS NPPES Program Update
- Peer-to-Peer Review Request Requirement Changes Effective September 1, 2022
- InterQual Criteria Rollout: Effective August 1, 2022
- Prior Authorization Change Summary: Effective July 1, 2022
- CPP 171: E&M Services Billed with Treatment Room Revenue Codes
- Medicare Billing Tips for Transplant Service Claims
- Prior Authorization Requirement Updates: Effective March 1, 2022
- Medicare Billing Updates Effective January 1, 2022
- 2022 Formulary Change Notification
- Claims & Payment Policy: Leg Stent Coding Updates
- Wellcare’s Provider Portal – Providers love our Live Chat!
- New Ophthalmology Medical Necessity Payment Policies
- National Imaging Associates (NIA) Implementation Announcement
- Wellcare’s Provider Portal – Now with Improved Live Chat
- Point of Care Formulary Information Tools
- CPP 161: Polymerase Chain Reaction Respiratory Viral Panel Testing
- New Somatus Care Management Program for patients with CKD/ESRD
- Claims and Payment Policy: Review of NOS, NEC, & Unlisted Codes
- Provider IVR Claims Menu Redesign
- New Portal Features: iCarePath Claim Appeals and Disputes
- New Prepay Edits: Institutional Ambulance Claims
- Prepayment Clinical Validations Edit Policy Effective October 1, 2020
- CPP 151: Frequency of Comprehensive Ophthalmological Exams
- $0 Member Liability extended for select services until end of 2020
- CPP 145: Incorrect Billing for Severe Malnutrition Policy
- CCG: Short Inpatient Hospital Stays Effective October 1, 2020
- Revised ED Outpatient Facility EM Coding Policies
- Opioid Program MAT Certification
- Prior Auth. Requirement Updates: Wound Care & Skin Substitutes
- CPP 133: 340B Drug Payment Reduction Policy
- Reducing Low Value Care Screenings Claims Edit Guidelines Policy
- Dialysis Claims Payment Policy
- Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy
- Medicare Milliman Clinical Guidelines (MCG) Rollout
- New Urine Drug Testing Guidelines
- Prior Authorization Requirements
- Annual Wellness Visit and Additional Physical Coding Refresher
- Readmission Policy Update
- New Modifier Claims Edit Guideline (CEG)
- Prior Authorization Requirements
- Exciting Authorization Rule Enhancements
- Your Partner in Quality Care
- Pharmacy Benefit Manager Effective January 1, 2016
- ICD-10 Transition Effective October 1, 2015
- Coding Reminder
- Inpatient Readmissions Policy
