04/28/26
Thank you for your continued partnership with Wellcare by Meridian. As you know, we are committed to continuously evaluating and improving overall Payment Integrity solutions as required by State and Federal governing entities. We are writing today to inform you of changes to existing review criteria that will go into place on or after 08/01/2026.
| Description of Changes | Lines of Business |
|---|---|
| Trend Data Mining: Payment Accuracy Services Trend's Payment Accuracy Services (PAS) expands upon Trend’s credit balance program to data mining. The data mining categories included within PAS offer recoveries related to Contractual Pricing, Duplicative Payments, Billing/Coding, Member Eligibility, and COB. All overpayment reviews will be contingent on provider approval and will follow established Centene Credit Balance workflows (e.g., CRP processes, file imports/exports). Trend’s concept library is informed by sources such as CMS billing and reimbursement guidelines, health plan payment policies, state Medicaid payment regulations, and provider contracts. |
Medicare, Medicaid, Marketplace, or Commercial |
Thank you for your continued cooperation in our ongoing efforts to render quality health care to our members. We look forward to helping you provide the highest quality of care for our members.
Sincerely,
Wellcare
