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Claims

WellCare of Nebraska wants to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely payment by having an understanding of our processes and requirements.

Learn about EFT/ERA Enrollment.

Welcome to the WellCare Provider Network!

This Welcome Letter will help your billing department get your EDI (claims and real time) transactions processed as efficiently as possible.

Institutional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837I EDI transactions.

Professional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Claims Samples and Guidelines

An example of a CMS 1500 Submission Form.

Instructions on how to submit a corrected or voided claim.

Providers are encouraged to submit claims with the correct taxonomy code consistent with the provider’s specialty and services being rendered in order to increase appropriate adjudication.

An example of a UB04 Submission Form

Helpful Information

Claims Submission Tips

  • Providers should include Payer ID 14163 on claims submissions.
  • As applicable, include Payer ID 59354 on claims encounter submissions.

EDI Notice

RelayHealth, a division of McKesson, manages all claims electronic data interchange (EDI) between Staywell and our providers. If you need assistance, please contact RelayHealth at 1-888-499-5465, or your vendor may call 1-888-743-8735.

Taxonomy

WellCare wants to continue to encourage providers to submit claims with the correct taxonomy code consistent with the provider's specialty and services being rendered in order to increase appropriate adjudication. WellCare may reject the claim or pay it at the lower reimbursement rate if the taxonomy code is incorrect or omitted.
  • Claims Submission Tips

    Claims Submission Tips

    • Providers should include Payer ID 14163 on claims submissions.
    • As applicable, include Payer ID 59354 on claims encounter submissions.
  • EDI Notice

    EDI Notice

    RelayHealth, a division of McKesson, manages all claims electronic data interchange (EDI) between Staywell and our providers. If you need assistance, please contact RelayHealth at 1-888-499-5465, or your vendor may call 1-888-743-8735.

  • Taxonomy

    Taxonomy

    WellCare wants to continue to encourage providers to submit claims with the correct taxonomy code consistent with the provider's specialty and services being rendered in order to increase appropriate adjudication. WellCare may reject the claim or pay it at the lower reimbursement rate if the taxonomy code is incorrect or omitted.
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Last Updated On: 8/9/2017
On September 1, 2018, our premium payment services changed. These changes will make it easier for you to pay your premium. Read more. ×