WellCare accepts secondary claims electronically. We encourage providers to submit Coordination of Benefits (COB) claims, which are essential to adjudicating claims correctly. COB claims can be directly submitted from:
- A provider who has received a remittance advice from the previous payer (provider-to-payer COB).
- The previous payer (payer-to-payer COB).
Tips for Submitting Coordination of Benefits Claims
In order to submit COB claims, your practice management system, data entry portal or clearinghouse must be able to:
- Create or forward claims in full HIPAA standard format (837) or in a format that contains equivalent information and includes necessary COB fields.
- Include electronic payment information received from the primary payer's HIPAA standard electronic remittance advice (ERA).
OR
- Include electronic payment information by converting the primary payer's paper Explanation of Benefits (EOB) into HIPAA standard coding used in an ERA.
Resource Guides
These guides contain more details about COB-related information:
- 5010 Professional and Institutional 837 Implementation Guides (section 1.4.1, pages 3-26), available from the Washington Publishing Company.
- WellCare Companion Guides.
For claims filing and EDI-related issues, please email WellCare's EDI Department.
