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Electronic Claims

FREE OPTIONS FOR PROVIDERS TO BILL ELECTRONIC SUBMISSIONS

WellCare encourages providers to submit claims electronically via electronic data interchange (EDI) or direct data entry (DDE). Both are less costly than billing with paper and often enable quicker claims processing.

  • Change Healthcare, formerly known as Relay Health, manages all EDI claims between WellCare and providers. If you need assistance making a connection with Change Healthcare or have any questions, please contact Change Healthcare directly at 1-877-411-7271, or your vendor may call 1-800-527-8133.
  • For EDI submissions, providers should follow the HIPAA transaction and code set requirements. More information can be found on the Washington Publishing Company website.
  • All Fee-For-Service (FFS) providers and vendors must send claims through a clearinghouse. For more details on payer ids and submission details, please see the quick reference guide for the members State/Product under Providers in the Tool Bar, select Overview.

Free Direct Data Entry (DDE) and Small Batch Uploads

  • WellCare offers a DDE tool, powered by AdminisTEP, providing non-participating and participating provider a user-friendly web browser for single submission direct data entry (DDE). The batch upload option is for providers with compatible practice management software that can submit 837 batch files.  These options for professional and institutional submissions, claim status and reporting and inquiry functions are at no cost to you.
  • Connect Center ™ for physicians offers a web browser for direct data entry (DDE) or batch upload capability at no cost to you. To sign up, please go to: https://physician.connectcenter.changehealthcare.com
    • For registry questions, submitter/clients may contact Provider Connectivity Services at 1-877-411-7271. Direct questions regarding functionality of Connect Center should be directed to the Clearinghouse at 1-800-527-8133, option 2.
    • Providers will be required to enter a credit card upon initial enrollment to verify them as a valid submitter.
    • Only WellCare submissions are free of charge.  Please ensure you use vendor code 212750 when you register.
    • Providers are required to use the WellCare Payer ID 14163 for FFS submissions sent through Connect Center.



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Last Updated On: 7/3/2017