Information and Resources on Hurricane Helene. Are you in North Carolina and need help because of Hurricane Helene? View the DPS website for helpful information.
Provider Resources
Provider Resources
Musculoskeletal Care Management and Interventional Pain Management Programs
WellCare of North Carolina by Celtic Insurance Company (WellCare) has partnered with Evolent (formerly National Imaging Associates, Inc.) to implement new Musculoskeletal Care ‘MSK’ Management and Interventional Pain Management ‘IPM” Programs. This program is intended to help providers easily and effectively deliver quality patient care.
WellCare provides the tools and support you need to deliver the best quality of care.
Reference Materials
- 2025 Provider & Billing Manual (PDF)
- 2024 Provider & Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Inpatient Authorization Form (PDF)
- Outpatient Authorization Form (PDF)
- Well-Being Survey (PDF)
- Member Notification of Pregnancy (PDF)
- Notification of Pregnancy Form (PDF)
- Provider Fax Back Form (PDF)
- Claim Dispute Form (PDF)
CMS Interoperability & Prior Authorization Final Rule: CY2025 Prior Authorization Requirements Reports and Metrics Summaries
In accordance with the Centers for Medicare & Medicaid Services (CMS) Final Rule (CMS 0057 F), we are annually publishing our prior authorization requirements and performance metrics to promote transparency, accountability, and better support our members and providers.
Reports:
- Wellcare of North Carolina by Celtic Ins Co. CMS Final Rule 0057-F Prior Authorization Requirements: 44007 (PDF)
- Wellcare of North Carolina by Celtic Ins Co. Prior Authorization Metrics Summary: 44007 (PDF)
The data presented in these publications reflects prior authorization requests processed during the applicable measurement year in accordance with CMS reporting specifications. Metrics are calculated using CMS defined methodologies and may not be directly comparable to alternative reports or third party summaries.