December 29, 2020
Letter of Authority to Engage in Third Party Resource Recoveries
Dear Health Insurance Carrier
WellCare of New Jersey is a managed care organization that serves the New Jersey Medicaid population under a contract with the New Jersey Department of Human Services. The contract and applicable state law authorizes WellCare of New Jersey to identify and collect appropriate amounts from third parties liable for costs incurred by WellCare of New Jersey for services provided to its Medicaid enrollees. The contract also permits WellCare of New Jersey to subcontract with vendors for such services.
WellCare of New Jersey has contracted with Health Management Systems, Inc. (“HMS”) to assist in performing third party liability identification and recovery services for WellCare New Jersey. In accordance with such contract, HMS has executed a business associate agreement.
In order to properly coordinate the receipt of benefits, HMS is permitted under its contract with WellCare of New Jersey to contact you directly to request your assistance. As an authorized business associate of WellCare of New Jersey, you may disclose any protected health information (PHI) directly to HMS on behalf of WellCare of New Jersey. This includes requests for your plan’s monthly eligibility roster and the processing of Medicaid Reclamation claims as they are submitted to you.
The contract between WellCare Health Plans and HMS was effective as of July 2006 and renews automatically every year.
Our local address: The remit address is:
WellCare Health Plans of New Jersey, Inc. NJ Medicaid
8735 Henderson Road PO Box 933690
Tampa, FL 33634 Atlanta, GA 31193-3690
If you require further information regarding third party liability issue, please contact Roger Fuentes at 813-206-3403 or via mail at 5520 W. Idlewild Ave., Tampa, FL 33634.
Thank you in advance for your cooperation.
Sincerely,
Roger Fuentes
Manager - Recovery Vendors, Payment Integrity
