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Timely Filing Claims must be received within 12 months from the date of service (DOS) or six months from the Medicare pay date whichever is longer, or within 12 months from the last Kentucky Medicaid denial. Please refer to the MCO if appealing an MCO claim.
Call us at 1-855-852-7005 to expedite a clinical appeal.
Claim payment appeals must be submitted in writing to WellCare within 24 months of the date on the EOP. All supporting documentation must be submitted along with the claim payment appeal request.
The following Wellcare plans offer Medicare Advantage Prescription Drug plan coverage to Kentucky residents. Medicare Advantage plus Prescription Drug plans are an alternative way to get your Original Medicare.
Beginning Jan. 1, 2022, Centenes Medicare brands, including Allwell, Health Net, Fidelis Care, Trillium Advantage, Ohana Health Plan, and TexanPlus will transition to the Wellcare brand.
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You can file by calling or writing to us. To file an appeal by phone, call 1-877-389-9457 (TTY 711 or 1-877-247-6272). IMPORTANT: If you call in your appeal, you must follow up with a written, signed request. Make sure to do this within 10 calendar days of calling in your appeal.

wellcare appeal form pdf