Wellcare billing and credentialing
Billing for Wellcare Medicare Advantage and prescription drug plans.
Working with Wellcare
Wellcare is Centene’s Medicare brand, offering Medicare Advantage HMO and PPO plans and dual-eligible special needs plans in many states.
Plan types we bill:
- Medicare Advantage HMO and PPO
- Dual-eligible special needs plans
Credentialing and enrollment
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
Wellcare claims follow Medicare Advantage rules, including plan prior authorization and referral requirements.
Denials we prevent with Wellcare
- Provider not credentialed or not linked to the group
- Out-of-area members not billed through BlueCard
- Missing prior authorization
- Coding and bundling edits under plan policy
- Late filing under the contract
Questions about Wellcare
Is Wellcare Medicaid or Medicare?
Wellcare is mainly Centene’s Medicare Advantage brand.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Wellcare 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.