2024
- WellCare of Maine transitions to Availity Essentials
- Sleep Study Authorization Changes
- Medicare Benefit Updates for 2024
- Annual Special Needs Plan Model of Care (MOC) Training
- Billing Professional HCFA1500 Ambulance Paper Claims to Wellcare
- Change Healthcare Cybersecurity Incident and its Impact to Wellcare
- MSK Management Program Announcement
- MSK Provider Education Webinars
- Medicare Step Therapy Part B Drug List - Effective January 1, 2024
- National Epic Payer Platform Announcement
- Find-a-Provider Directory Communications: Phase 1
- Important Pharmacy Claims Processing Change, Effective January 1, 2024
2023
- Medicare Prior Authorization Changes Effective October 1, 2023
- Annual Special Needs Plan Model of Care (MOC) Training
- Reminder: Home Health Notice of Admission (NOA) Change
- Termination of Somatus Care Management Program for Patients with CKD/ESRD
- COVID-19 Public Health Emergency (PHE) Expiration - Effective May 11, 2023
- Medicare Prior Authorization Change Summary - Effective July 1, 2023
- Appendix A - Medicare Part B Drug List - Effective July 1, 2023
- Reminder of CMS Lab Ordering Guidelines
- D-SNP Patients Must Verify Medicaid Eligibility Annually
- New Century Health Oncology Prior Authorization List: Effective April 1, 2023
- Wellcare 2023 $0 Immunizations Part D Vaccines - (PDF)
- Special Needs Plan Model of Care Self-Study Program
- Medicare Part B Drugs List: Effective January 1, 2023 (Appendix A)
- Medicare Prior Authorization Change Summary: Effective January 1, 2023
- CMS Lab Ordering Guidelines Reminder
- Sneak Preview of 2023 Improvements
2022
- New Cardiac Surgical Quality and Safety Management Program with TurningPoint
- Medicare Provider CMS NPPES Program Update
- Peer-to-Peer Review Request Requirement Changes Effective September 1, 2022
- InterQual Criteria Rollout: Effective August 1, 2022
- Prior Authorization Change Summary: Effective July 1, 2022
- CPP 171: E&M Services Billed with Treatment Room Revenue Codes
- Medicare Billing Tips for Transplant Service Claims
- Prior Authorization Requirement Updates: Effective March 1, 2022
2021
- Medicare Billing Updates Effective January 1, 2022
- 2022 Formulary Change Notification
- Claims & Payment Policy: Leg Stent Coding Updates
- Wellcare’s Provider Portal – Providers love our Live Chat!
- New Ophthalmology Medical Necessity Payment Policies
- National Imaging Associates (NIA) Implementation Announcement
- Wellcare’s Provider Portal – Now with Improved Live Chat
- Point of Care Formulary Information Tools
- CPP 161: Polymerase Chain Reaction Respiratory Viral Panel Testing
- New Somatus Care Management Program for patients with CKD/ESRD
2020
- Claims and Payment Policy: Review of NOS, NEC, & Unlisted Codes
- Provider IVR Claims Menu Redesign
- New Portal Features: iCarePath Claim Appeals and Disputes
- New Prepay Edits: Institutional Ambulance Claims
- Prepayment Clinical Validations Edit Policy Effective October 1, 2020
- CPP 151: Frequency of Comprehensive Ophthalmological Exams
- $0 Member Liability extended for select services until end of 2020
- CPP 145: Incorrect Billing for Severe Malnutrition Policy
- CCG: Short Inpatient Hospital Stays Effective October 1, 2020
- Revised ED Outpatient Facility EM Coding Policies
- Opioid Program MAT Certification
- Prior Auth. Requirement Updates: Wound Care & Skin Substitutes
- CPP 133: 340B Drug Payment Reduction Policy
