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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 and Payment Policy
Renal Dialysis Facility and Professional 
Claims and Payment Policy Intensity Modulated Radiation Therapy (IMRT) Facility and Professional
Claims and Payment Policy Emergency Department Radiology Utilization Facility and Professional
Claims and Payment Policy Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing Lab
Claims and Payment Policy Inpatient Notification Facility
Claims and 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: 1/17/2020
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