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Claims

WellCare wants to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements.

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.

Dental Claims/Encounter Guides

Other Resource Guides

Instructions on how to submit a corrected or voided claim.

Explains how to receive, load and send 834 EDI files for member information.

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Last Updated On: 6/5/2017