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Claims

WellCare of New York wants to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely 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.

Other Resources

We would like to help your billing department get your EDI (claims and real time) transactions processed as efficiently as possible.

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

Helpful Information

Claims Submission Tips

  • Providers should include Payer ID 14163 on claims submissions.
  • As applicable, include Payer ID 59354 on claims encounter submissions.
  • Claims samples and guidelines

 

EDI Notice

RelayHealth, a division of McKesson, manages all claims electronic data interchange (EDI) between Staywell and our providers. If you need assistance, please contact RelayHealth at 1-866-855-4723, or your vendor may call 1-888-743-8735.

  • Claims Submission Tips

    Claims Submission Tips

    • Providers should include Payer ID 14163 on claims submissions.
    • As applicable, include Payer ID 59354 on claims encounter submissions.
    • Claims samples and guidelines

     

  • EDI Notice

    EDI Notice

    RelayHealth, a division of McKesson, manages all claims electronic data interchange (EDI) between Staywell and our providers. If you need assistance, please contact RelayHealth at 1-866-855-4723, or your vendor may call 1-888-743-8735.

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Last Updated On: 12/21/2015