June 28, 2022
Thank you for your continued partnership with Wellcare. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of new policies Wellcare will be implementing effective on or after August 1, 2022.
|Line of Business
|Claims Xten Optimization – NCD Alignment
|Adding prepay reviews for several national coverage determinations (NCDs) to be in accordance with CMS guidelines for correct coding.
For detailed information about these policies, please refer to our website at https://www.wellcare.com/Texas/Providers/Medicare/Claims/Payment-Policy. And for questions about this or any of our payment policies, please don't hesitate to reach out to our Provider Services team at 1-855-538-0454.