Effective June 30, 2012, WellCare no longer offers the MO HealthNet Managed Care Program, Harmony Health Plan of Missouri.
Harmony Health Plan of Missouri members had access to covered benefits through June 30, 2012, or through their disenrollment date, if earlier.
Providers should continue to bill for covered services rendered for eligible dates of service. Claims will be accepted through June 30, 2013.
The discontinuation of WellCare’s Harmony Health of Missouri does not affect WellCare Medicare Advantage HMO (coordinated care) or prescription drug plan (PDP) members in Missouri.
The Administrative Simplification Provision of the Health Insurance Portability and Accountability Act (HIPAA) requires standards for electronic transactions, such as claims (including pharmacy), remittance, eligibility and claims status. The current versions of these standards, X12 Version 4010/4010A1 and NCPDP Version 5.1 will be replaced with Version 5010 and Version D.0, respectively. The federally mandated compliance date is January 1st, 2012, but in alignment with CMS’ grace period on enforcement action, WellCare will allow both 4010 and 5010 transactions to be submitted until June 30th, 2012. Click here for more information.
Important Changes in Electronic Data Interchange (EDI) Process – effective July 24, 2011
Harmony accepts electronic claims only through RelayHealth, a division of McKesson. If your vendor (i.e., practice management system , billing server, or clearinghouse) is not connected to RelayHealth, we strongly encourage you to contact them directly and request that they establish this FREE connection. Upon confirmation from your vendor of continued electronic claims submission to Harmony via RelayHealth, no further action is necessary. If you have questions regarding submission of EDI transactions directly through RelayHealth, please see the provider notice and FAQs for more information, or refer to your Quick Reference Guides for contact information for providers and vendors.
As part of the Harmony network of providers, you can take advantage of a variety of services available on this site to manage your Harmony online account. Your user name and password are required to access our secure provider only portal.
Register today! Sign Up Here