As of April 1, 2021, all WellCare of South Carolina Medicaid members will transfer to Absolute Total Care. All dates of service prior to 4/1/2021 should be filed to WellCare of South Carolina. For additional information, questions or concerns, please contact your local Provider Network Management Representative. How do I determine if a professional or an outpatient bill type institutional submission should be filed to WellCare or Absolute Total Care? Or you can have someone file it for you. We would like to help your billing department get your EDI (claims and real time) transactions processed as efficiently as possible. Providers are encouraged to visit the Provider Resources webpagefor manuals, forms, and resources related to claims submission, eligibility, prior authorization, and more. Absolute Total Care will honor those authorizations. Box 600601 Columbia, SC 29260. Wellcare wants to ensure that claims are handled as efficiently as possible. South Carolina Medicaid Provider Resource Guide - WellCare We will do this as quickly as possible as but no longer than 72-hours from the decision. Explains how to receive, load and send 834 EDI files for member information. We cannot disenroll you from our plan or treat you differently. Contact Absolute Total Care Provider Service at1-866-433-6041if youhave questions. Only you or your authorizedrepresentative can ask for a State Fair Hearing. You can ask for a State Fair Hearing after we make our appeal decision. Providers interested in joining the Absolute Total Care Provider Network should submit a request to Network Development and Contracting via email at atc_contracting@centene.com. The current transaction means that WellCare of South Carolina Medicaid members are transitioning to Absolute Total Care and will become Absolute Total Care members, effective April 1, 2021. Claims | Wellcare Guides Filing Claims with WellCare. Timely filing is when you file a claim within a payer-determined time limit. You or your authorized representative will tell the hearing officer why you think we made the wrong decision. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements. Stay informed - activate your online account Behavioral Health Crisis Line 844-594-5076 (TTY 711) 24 hours a day, seven days a week Call us if you are experiencing emotional or mental pain or distress. They must inform their vendor of AmeriHealth Caritas . For dates of service on or after April 1, 2021: Absolute Total Care Welcome to WellCare of South Carolina | Wellcare Q. Continuation of Benefits During the Appeals Process We will continue covering your medical services during your appeal request and State Fair Hearing if all of the following are meet. 1096 0 obj <>stream Do I need to do anything additional to provide services on or after 4/1/2021 if I am in network with both WellCare and Absolute Total Care? Can I continue to see my current WellCare members? It is called a "Notice of Adverse Benefit Determination" or "NABD." Q. Members must have Medicaid to enroll.
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