WellCare (Encounters)
dentalmedicalvision
Summary
WellCare (Encounters) is a dental, medical, and vision payer with nationwide coverage. Claims route under payer ID 59354, with 2 alternate IDs in use across clearinghouses. Through clearinghouses it supports eligibility checks, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.
At a glance
- Payer ID
59354Also seen as 3211, 4949- Also known as
- Wellcare Health Plans
- Service area
- Nationwide
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | Several weeks |
Common questions
- What is the payer ID for WellCare (Encounters)?
- The payer ID for WellCare (Encounters) is 59354. Alternate IDs seen across clearinghouses include 3211, 4949.
- Does WellCare (Encounters) require ERA enrollment?
- Yes. WellCare (Encounters) requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
- What states does WellCare (Encounters) cover?
- WellCare (Encounters) operates in Nationwide. Coverage can differ by plan and product line, so confirm the specific plan before you file.
- What types of coverage does WellCare (Encounters) offer?
- WellCare (Encounters) covers dental, medical, and vision.
- Can I submit claims to WellCare (Encounters) electronically?
- Yes. WellCare (Encounters) is reachable through clearinghouses for eligibility checks, professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).
Related payers
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.