Skip to main content

Medicare Synergy Edits

Dear Provider,

Thank you for your continued partnership with Wellcare. 

As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members.  We are writing today to inform you of new policies Wellcare will be implementing effective on or after March 1, 2023.

Initiative Name Description Lines of Business
Medicare Synergy Edits Implementing correct coding edits in accordance with CMS and AMA guidelines to align. Edits cover the following areas: Durable Medical Equipment, Drugs and Biological, Modifiers, Podiatry, Laboratory-Pathology, Evaluation & Management, Incision and Drainage, Frequency, Bundled Facility, and Vitamin D Testing.  Xcelys Medicare

For detailed information about these policies, please refer to our website at wellcare.com/Michigan/Providers.
For questions about this or any of our payment policies, please don’t hesitate to reach out to our Provider Services team at 1-855-538-0454.

Sincerely,
Wellcare

Contact Us icon

Need help? We're here for you.

Contact Us
Last Updated On: 5/12/2023
Wellcare will be performing maintenance on Saturday, December 21, from 6 P.M. EDT to 8 A.M. EDT the next day. You might not be able to access systems or fax during this time. We are sorry for any issues this may cause. Thank you for your patience. If you need assistance, contact us. ×