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Payment Policy

This notice is to clarify a segment of WellCare's payment policy language applicable to all WellCare Medicaid markets. WellCare's payment policies are based on publicly distributed guidelines from established industry sources such as the Centers for Medicare and Medicaid Services (CMS), the American Medical Association (AMA), state health care agencies and medical specialty professional societies.

If you have questions about this information, please contact your Provider Relations representative.

Policy Description Claim Type
Claims & Payment Policy  Intensity Modulated Radiation Therapy (IMRT)   Facility and Professional
Claims & Payment Policy  Emergency Department Radiology Utilization Facility and Professional 
Claims & Payment Policy
Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing
Lab 
Claims & Payment Policy  Inpatient Notification

Facility  

Claims & Payment Policy 

Pre-Payment and Post-Payment Review 

 Facility and Professional
Claims and Payment Policy  Screening for Colorectal Cancer Using Cologuard – A Multitarget Stool DNA Test  Facility and Professional 

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Last Updated On: 5/31/2019