Dear Valued Provider:
Wellcare Health Plans has contracted with CareCentrix to manage home health services for our Medicare and SNP members in New York effective October 1, 2022.
Here are the key details:
- CareCentrix will manage authorizations for Medicare and SNP home health services.
- CareCentrix will contract, credential, and manage a network of independent home health agencies for Medicare and SNP members.
- Independent home health agencies will need to sign a new contract directly with CareCentrix prior to October 1, 2022, to remain a participating provider.
- CareCentrix will manage claims for Medicare and SNP home health services rendered by independent home health agencies.
- CareCentrix will not contract, credential, or manage a network of hospital-owned home health agencies for Medicare and SNP members. Wellcare will retain this responsibility, along with claims management for these agencies.
- These changes will not affect contracts, authorizations or claims for other lines of business with Wellcare.
If home health providers do not obtain authorization from CareCentrix for Medicare and SNP home health services on or after October 1, 2022, claims may be denied.
Independent home health agencies will be required to submit claims to CareCentrix for Medicare and SNP home health services delivered on or after October 1, 2022. If claims are submitted to Wellcare, they will be rejected.
CareCentrix will contact you shortly to provide information about training for authorization and/or the claims process you will begin using on October 1, 2022. Independent home health agencies will also receive information about the contracting process.
If you have questions about Wellcare services, please call Provider Services at 1-833-444-9089 or contact your provider relations representative.
Vice President, Provider Relations