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WellCare will be performing maintenance on Saturday, December 21, from 6 P.M. EDT to 8 A.M. EDT the next day. You might not be able to access systems or fax during this time. We are sorry for any issues this may cause. Thank you for your patience. If you need assistance, contact us.

New Evolent Cardiology Program – Authorization Codes Beginning May 1, 2024

WellCare of North Carolina (WellCare) has partnered with Evolent (formerly New Century Health) to implement a new outpatient Cardiology Management Programs. This program is intended to help providers easily and effectively deliver quality patient care.

Effective May 1, 2024, cardiology invasive procedures services will require prior authorization through Evolent rendered in a physician’s office, outpatient hospital, ambulatory, or inpatient setting (planned professional services only) will require prior authorization through Evolent. WellCare authorizations issued before May 1, 2024, will be effective until the authorization end date. This management programs will apply to your WellCare Medicaid members 18 years of age and older. For members under age 18, authorizations must be obtained from WellCare of North Carolina.

See a list of the Authorizations codes (PDF) and important FAQs (PDF) for more information.

Prior authorization requests for invasive cardiology services can be submitted to Evolent:
• Online my.newcenturyhealth.com.
• Via telephone at 1-888-999-7713, (Option 1) Staff is available Monday-Saturday from 8:00 a.m. to 8:00 p.m. EST.

Evolent uses clinical criteria based on nationally recognized guidelines to promote evidence-based practices. When using Evolent’s web portal, you will be able to:
• Obtain real-time approvals when selecting evidence-based treatment care pathways
• Determine the clinical documentation required for medical necessity review
• View all submitted requests
• Request to speak with clinicians to discuss treatment options

WellCare is proud to be your healthcare partner. If you frequently request cardiology services and are new to this process, Evolent representatives will contact you soon to schedule an introductory meeting and training.

If you have questions about the Evolent invasive cardiology services program, please email providertraining@newcenturyhealth.com or call 1-888-999-7713, (Option 6). For any other questions, reach out to your WellCare provider rep or email ncproviderrelations@wellcare.com.

We look forward to working with you.