Wellcare wants 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.
Start Submitting Electronic Claims
- Sign up for the Provider Portal, or
- Register for Availity (for support call 1-800-AVAILITY (282-4548), or
- Contact Provider Engagement Account Managers by email at providerrelations@iowatotalcare.com.
Timely Claims Submission
- Clean Claims (initial, corrected and voided) must be submitted within 180 calendar days from the date of service or from the date of discharge (for inpatient services).
- Claims Payment Disputes must be submitted in writing within 90 calendar days of the date of denial of the Explanation of Payment (EOP).
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.
- Reimbursement Policies (PDF)
- Clinical Laboratory Improvement Amendments (CLIA) (PDF)
- Medicare Claims Payment Policies - Coming Soon
