Dear Valued Provider,
This notification is a reminder that all laboratory services ordered STAT require you to initiate a prior authorization. Laboratory tests ordered STAT are normally resulted within 2-4 hours of specimen pick-up. As outlined in your Wellcare Network Services Agreement and the Provider Manual, participating physicians are responsible for initiating and obtaining prior authorizations for certain medical services. The health plan's prior authorization guidelines include CPT 99199, normally billed by LabCorp to perform STAT pick up services.
This is supported by, and can be verified, via our Authorization Lookup tool at https://www.wellcare.com/en/Florida/Providers/Authorization-Lookup.
Please establish medical necessity when calling to initiate a prior authorization for ordering laboratory services as STAT. The health plan will review the prior authorization request and make a determination if STAT services are medically necessary.
Authorizations can be submitted via the Secure Provider Portal or via fax to:
1-800-935-5752.
If you have any questions, please contact Wellcare Provider Relations at
1-407-551-3200, option 2, or sunshineproviderrelations@sunshinehealth.com.
Sincerely,
Duenna Dorsett
Vice President, Provider Engagement
Wellcare Health Plans, Inc.
