Providers

New Coding Integrity Reimbursement Guidelines

WellCare Health Plans, Inc. is committed to continuously improving its claims review and payment processes.

Effective 02/01/2019 we will introduce new Coding Integrity Reimbursement Guidelines  based on industry standards, coding rules published within the Medicare Claims Processing Manual, Current Procedural Terminology (CPT^®)  by the American Medical Association (AMA) and ICD-10-CM guidelines governed by Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS). These are the same rules used by most healthcare claims payers and enforced by the Centers for Medicare and Medicaid Services.