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Payment Policy

This notice is to clarify a segment of WellCare's payment policy language applicable to all WellCare Medicaid markets. WellCare's payment policies are based on publicly distributed guidelines from established industry sources such as the Centers for Medicare and Medicaid Services (CMS), the American Medical Association (AMA), state health care agencies and medical specialty professional societies.

If you have questions about this information, please contact your Provider Relations representative.

Policy Description Claim Type
Claims & Payment Policy
Intensity Modulated Radiation Therapy (IMRT)  Facility and Professional 
Claims & Payment Policy
Emergency Department Radiology Utilization Facility and Professional 
Claims & Payment Policy
Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing  Lab

Claims & Payment Policy

Inpatient Notification

 Facility

Claims & Payment Policy

Pre-Payment and Post-Payment Review Facility and Professional
Claims & Payment Policy
Screening for Colorectal Cancer Using Cologuard – A Multitarget Stool DNA Test  Facility and Professional 
Claims & Payment Policy
Colorectal Cancer Screening
 Facility and Professional 
Claims & Payment Policy
Prostate Cancer Screening
 Facility and Professional 
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Last Updated On: 8/20/2019
Medicare and Prescription Drug Plan Members: A new and enhanced member portal will soon be available. This portal will offer a fresh homepage, all new billing and payment options for 2020, and more! Check back on 10/15 to see what else is new. ×