Events
Contact Us
Newsletter Sign-up
Client Login
 
573.335.4715
News Details


Missouri Care Claim Improvements

Claims Research Process Improvements

Missouri Care is implementing improvements to their claims research process effective 4/8/19. If you have a claim you believe processed incorrectly, we have the following services available to you:
 
Customer Service
Your first line of resolution is our Customer Service Team. They are available to answer your calls regarding claim status or if you believe a claim processed incorrectly. Customer Service will provide a reference number for your call – please document this number with your claim(s).
 
New Web Portal Live Chat Feature
Claims assistance and Customer Service is available via Live Chat through our secure Web Portal at https://provider.wellcare.com/missouricare.
 
Claims Dispute Process
This process is required if you’re unable to receive resolution to your claim issue through our Customer Service Department. Claim Disputes can be filed through Customer Service on your behalf, via our Provider Web Portal or by fax at 1-877-277-1808 Attn: Claims Dispute Team.
 
Operations Account Rep (OAR) Team
If you disagree with the dispute resolution provided to you, or you have not received a response within 45 days, the OAR team can research and perform root cause analysis on claims you believe were processed incorrectly. This is a service we provide to bring resolution to your claim questions and issues that were unable to be resolved by either Customer Service or the Claims Dispute team.

How It Works:
Step 1: Complete the attached Provider Information and Contact Form along with the Claims Research Spreadsheet. Any missing information from the required fields may cause either document to be returned.
Step 2: Email the completed form and spreadsheet to ProvClaimSubmission@wellcare.com with the following subject line: Your PR Rep’s Name (Christa Hudson), Your Group Name, Brief Description of the Issue (ex. subject line: Christa Hudson, Dr. John Doe, Claims Denied for No Auth).
Step 3: Within 1-2 business days of receiving your request, you will receive an email from the Operations Account Rep assigned to research your claim issue and provide you with the ticket number assigned to the issue.

The improvements to the claims research process will result in faster submission of your claims issues at it will eliminate "the middle man" and allow the OAR Team to directly research the rood cause of your claims issues, if needed.

Provider Relations
Missouri Care | WellCare Health Plans, Inc