Wellpoint billing and credentialing
Billing for Wellpoint plans, the Elevance Health brand that replaced Amerigroup in many states.
Working with Wellpoint
Elevance Health has rebranded its Amerigroup Medicaid and Medicare plans as Wellpoint in many states. Member cards and payer names changed, but many plan IDs and contracts carried over, so we confirm the current payer setup for each state.
Plan types we bill:
- Medicaid managed care
- Medicare Advantage and dual plans
- Marketplace plans in some states
Credentialing and enrollment
For Medicaid products, you must first be enrolled with the state Medicaid agency, then credentialed with the plan.
Credentialing uses your CAQH ProView profile, which must be complete and re-attested every 120 days.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Wellpoint uses Availity for eligibility, claims and authorizations, like other Elevance plans.
Denials we prevent with Wellpoint
- Provider enrolled with the state but not credentialed with the plan
- Member assigned to a different plan this month
- Missing plan prior authorization
- Behavioral health or vision carved out to another vendor
- State-specific coding or modifier rules not followed
Questions about Wellpoint
Our patients still have Amerigroup cards. Is that a problem?
Usually not, but we confirm the correct payer ID and plan so claims are not rejected during the transition.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Wellpoint claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.