For dates of service on or after Aug. 5th, 2017, we are standardizing authorization requirements across ALL outpatient places of service for our Medicare services.
- We have reduced the CPT codes that require an outpatient authorization requirements by over 60%
- Our outpatient authorization requirements will be applied across all services rendered in all outpatient settings.
- Other UM thresholds and rules such as high dollar DME claims will continue although we have increased some of the thresholds.
For questions regarding this notice, please contact Provider Services at 1-855-538-0454 between 8 a.m. and 6:30 p.m. When prompted say Authorizations or press 2.
Thank you for your continued participation and cooperation in our ongoing efforts to render quality health care to our members. We look forward to helping you provide the highest quality of care for our members.
WellCare Health Plans, Inc.