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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.

Reimbursement Policies

From time to time, WellCare Health Plans reviews its reimbursement policies to maintain close alignment with industry standards and coding updates released by health care industry sources like the Centers for Medicare and Medicaid Services (CMS), and nationally recognized health and medical societies.

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

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Last Updated On: 2/5/2019
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