Chuyển đến nội dung chính

Claims

WellCare of North Carolina will begin to release medical payments to providers beginning July 6, 2021. We process check runs daily, with the exception of Sundays, National Holidays, and the last day of the month.

Want to receive your payments faster to improve cash flow? You now have access to a secure, quick way to electronically settle claims. WellCare offers participating providers EFT and ERA services at no charge through PaySpan Health. Register now at https://www.payspanhealth.com or contact PaySpan at providersupport@payspanhealth.com, or 877-331-7154. Payments mailed to providers are subject to USPS mailing timeframes. Providers are encouraged to sign up to receive EFT payments to avoid any payment delays.

We want to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements.

Reimbursement Policies

From time to time, WellCare Health Plans reviews its reimbursement policies to maintain close alignment with industry standards and coding updates released by health care industry sources like the Centers for Medicare and Medicaid Services (CMS), and nationally recognized health and medical societies.

Filing Claims with WellCare

We would like to help your billing department get your EDI (claims and real time) transactions processed as efficiently as possible. WellCare has partnered with Change Healthcare as our preferred EDI Clearinghouse.

Institutional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837I EDI transactions.

Professional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Dental Claims/Encounters Guides

Other Resource Guides

Explains how to receive, load and send 834 EDI files for member information.

North Carolina PHP Billing Guidance for Local W Code

Instructions on how to submit a corrected or voided claim.

Liên H Vi Chúng Tôi

Cần trợ giúp? Chúng tôi luôn sẵn sàng hỗ trợ.

Liên Hệ Với Chúng Tôi
Last Updated On: 6/18/2021