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Updates to Prior Authorization Requirements

01/01/2020, there will be changes to the authorization requirements for services you may order or render for our members. These authorization changes may include services performed by the following vendor(s):

 HealthHelp (Radiation Therapy, Medical Oncology)
• EviCore (PT, OT, Sleep Medicine, Lab, Pain Management, Cardiology, Radiology)

On 01/01/2020, WellCare Health Plans, Inc. will be making updates to reflect these changes on the authorization lookup tool www.wellcare.com/auth_lookup. 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, and for additional assistance please feel free to contact the Provider Services Dept. 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.


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Last Updated On: 12/2/2019