Coverage profile
Work WellCare (Encounters) across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with WellCare (Encounters).
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for WellCare (Encounters).
Other aliases
Also known as
- 3211
- 4949
- 59354
- Wellcare Health Plans
- WELLCARE HEALTH PLAN INCORPORATED (ENCOUNTERS ONLY)
- WELLCARE
2027 maternity billing research
When does WellCare (Encounters) change OB/GYN billing?
CC.PP.016 describes global maternity bundling and prepayment claims review for adopting health plans. It contains no 2027 code-deletion implementation instructions and does not establish encounter-specific submission requirements for this record.
- Transition start
- No 2027 transition date stated in cited policy
- Billing start
- No 2027 billing date stated in cited policy
- Published
- Not stated in source
- Current As Of
- August 2026
Scope: Corporate template for medical maternity payment; WellCare Medicare-product adoption, effective date and encounter-reporting applicability are unverified. No dental or vision billing application is established.
CC.PP.016 Reporting the Global Maternity Package. Verify the payer source before claim submission.
Frequently asked questions
WellCare (Encounters) payer FAQs
Can I automate WellCare (Encounters) portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for WellCare (Encounters)?
The primary payer ID for WellCare (Encounters) is 59354. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for WellCare (Encounters)?
The provider portal for WellCare (Encounters) is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for WellCare (Encounters)?
The 837P and 837I payer ID for WellCare (Encounters) is 59354 via Stedi.
What is the 835 payer ID for WellCare (Encounters)?
The 835 payer ID for WellCare (Encounters) is 59354 via Stedi.
What is the 270 payer ID for WellCare (Encounters)?
The 270 payer IDs for WellCare (Encounters) are 59354 via Stedi and 14163 via Availity.
What is the 276 payer ID for WellCare (Encounters)?
The 276 payer ID for WellCare (Encounters) is 14163 via Availity.
Routing reference
WellCare (Encounters) payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | WellCare (Encounters)Source: Substrate payer directory · data last changed |
|---|---|
| 837P professional claims payer IDStedi | 59354Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 59354Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 59354Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 59354Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 14163Source: Availity payer catalog · catalog dated · matched by payer name |
| 276 claim status payer IDAvaility | 14163Source: Availity payer catalog · catalog dated · matched by payer name |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: WellCare (Encounters). Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer name; matched records: WELLCARE, WELLCARE HEALTH PLANS. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Wellcare. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.