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WellCare (Encounters)

The provider portal for WellCare (Encounters) is https://apps.availity.com/

Primary payer ID
59354Compare transaction IDs ↓
Last successful claim statusWithin the past 48 hoursObserved across Substrate's claim-status network.
SupportedEDI 270/271Browser automation

Is your practice experiencing high volumes of no response claims or denials from WellCare (Encounters)? Try Substrate Denial Intelligence here -->.

Coverage profile

How Substrate can help you with WellCare (Encounters)

Substrate can help practices and billers with the following claims tasks for WellCare (Encounters).

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with WellCare (Encounters).

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for WellCare (Encounters).

Available

2027 maternity billing research

When does WellCare (Encounters) change OB/GYN billing?

Current policy only

No corporate 2027 start date found. The current template supports global maternity billing and code-audit review, but it is effective only when adopted by a specific Centene health plan on that plan's own date.

Transition start
Not published
Billing start
Not published
Published
Not stated in source
Current As Of
August 2026

Scope: Centene corporate template; state-plan adoption must be verified

Open WellCare (Encounters) in the payer explorer →
Direct policy ↗Upstream page ↗

CC.PP.016 Reporting the Global Maternity Package. Verify the payer source before claim submission.

Frequently asked questions

WellCare (Encounters) payer FAQs

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.

Resource library

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.

WellCare (Encounters) payer name, operating states, and transaction-specific payer IDs
Payer nameWellCare (Encounters)Source: Substrate payer directory · last refreshed
837P professional claims payer IDStedi59354Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi59354Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi59354Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi59354Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvaility14163Source: Availity payer catalog · catalog dated · matched by payer name
276 claim status payer IDAvaility14163Source: Availity payer catalog · catalog dated · matched by payer name

Routing sources and verification

  • Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .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.

Other aliases

Also known as

  • 3211
  • 4949
  • 59354
  • Wellcare Health Plans
  • WELLCARE HEALTH PLAN INCORPORATED (ENCOUNTERS ONLY)
  • WELLCARE