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Wellcare By Allwell Policy Update for October 2022

Date: 08/15/22

Thank you for your continued partnership with Sunflower Health Plan. As you know, we continually review and update our payment and utilization policies to ensure that they comply with industry standards while delivering the best patient experience to our members.

We would like to inform you of a new Wellcare By Allwell (Medicare) policy. Sunflower Health Plan will be implementing the following payment policy, effective on or after October 1, 2022.

  • Claims Xten Optimization – NCD Alignment - Adding prepay reviews for several national coverage determinations (NCDs) to be in accordance with CMS guidelines for correct coding.

For detailed information about this policy, please refer to CMS.gov.

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call Wellcare By Allwell Provider Services at:

  • HMO 1-855-565-9519
  • HMO D-SNP 1-833-402-6707
  • PPO 1-833-696-0634
  • TTY 711