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Updates to Prior Authorization Requirements: Effective March 1, 2022

Dear Valued Provider,

Wellcare By‘Ohana Health Plan has an important update to share with you.

There will be changes to the authorization requirements for services you may order or render for our members. These authorization changes may include lab services, genetic testing and/or services performed by the following vendor.  However, all approvals and denials will continue to be made by Wellcare Utilization Management team.

  • Turning Point (Orthopedic Surgery and Spinal Surgery)

On March 1, 2022, Wellcare will be making updates to reflect these Medicare changes on the authorization lookup tool at Prior authorization requirements are subject to periodic changes. You should always use our website’s authorization page to determine whether a procedure code requires prior authorization, and always check eligibility and confirm benefits before rendering services to members. Failure to do so may result in denial of reimbursement. 

For questions regarding this notice, please refer to the Quick Reference Guide. For additional assistance, please feel free to contact Customer Service at 1-866-319-3554. We are available Monday through Friday from 7:45 a.m. to 4:30 p.m. HST. The phone number is located in the Quick Reference Guide. When prompted, say “Authorizations” or press 2, for assistance.

Thank you for your continued participation and cooperation in our ongoing efforts to provide quality healthcare to our members.

‘Ohana Health Plan


PRO_92801E_Internal Approved 01052022
©Wellcare 2022

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Last Updated On: 1/6/2022