WellCare supports our provider partners by continually reviewing medical claims for accuracy and efficiency. This ensures we can continue to offer quality incentive programs and quick claims payments.
LabCorp is the exclusive statewide lab provider for WellCare of Florida. During a recent review, however, we found that your practice used a high number of out-of-network or non-preferred laboratories.
As a contracted physician with WellCare, please remember that you must refer your covered patients to LabCorp. This helps us reduce medical costs and potential out-of-pocket expenses for our members, and lets us record Healthcare Effectiveness Data and Information Set (HEDIS®) results.
Please remember that when you send our members to network laboratories, you help us control patient costs. This helps both WellCare and our members.
What are the next steps?
Because of the high number of referrals to out-of-network laboratories, we will review your laboratory referrals for our members. During that time, if referrals to out-of-network or non-preferred laboratories continue:
- You should explain to the patients that they may have to pay more if they use an out-of-network laboratory.
- We may speak to you about requirements of your contract and policies. The continued use of non-participating laboratories could result in the termination of your contract with WellCare
For the most up-to-date list of our network laboratories, please visit www.wellcare.com/florida/find-a-provider#/Search.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
Do you have any questions or concerns about our laboratory network? If you do, please call your Provider Representative or call Staywell Customer Service at 1-866-334-7927 or Children’s Medical Services (CMS) at 1-866-799-5321, 8 a.m. – 7 p.m.
Sincerely
WellCare Health Plans
