Skip to Main Content

Provider Digest | Volume 192

Date: 10/15/25

Effective October 1, 2025: Wellcare Medicare Prior Authorization Change Summary

Effective October 1, 2025, Wellcare By Health Net and Wellcare By Trillium Advantage are notifying all participating Medicare providers that prior authorization will no longer be required for a series of computed tomography (CT) and transthoracic echocardiogram procedure codes.

The comprehensive list of procedure codes affected by this notification are provided below:

Procedure Codes No Longer Requiring Prior Authorization Effective October 1, 2025

  • Chest CT: 71250, 71260, 71270, 0722T
  • CT for Low Dose Lung Cancer Screening: 71271
  • CT of the Pelvis and Abdomen: 74176, 74177, 74178, 0722T
  • Transthoracic Echocardiogram: 93303, 93304, 93306, 93307, 93308, 93320, 93321, 93325, 93356

Please Note:

  • Non-participating providers require authorization for all HMO services, except where indicated. A complete CPT/HCPCS code list can be viewed in the online Medicare Prior Authorization Tool.
  • It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.
  • Please verify eligibility and benefits for all members prior to rendering services. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered.

For additional assistance, please contact your assigned health plan Provider Engagement Administrator:

______________________________________________________

Reminder: New Provider Engagement Email Box for Trillium, Health Net and Wellcare Providers

Effective September 15, 2025, we consolidated our Provider Engagement email addresses to a single email address that can be used by all of our Trillium, Health Net and Wellcare providers. For more details, review the original article below. And please add the new ORProviderExperience@TrilliumCHP.com email box to your contact list and remove the old email boxes that are set to decommission on October 15, 2025. Thank you!

New Provider Engagement Email Box for Trillium, Health Net and Wellcare Providers
Starting September 15, it will be even easier to interact with our health plans! To streamline your experience, you will be able to reach your Trillium, Health Net and Wellcare Provider Engagement Team through the same email address!

What is changing on September 15, 2025?

  • New Trillium, Health Net and Wellcare Provider Engagement email box: Trillium, Health Net and Wellcare providers can reach us through one Provider Engagement team email box: ORProviderExperience@TrilliumCHP.com. Save this email address in your contacts and use it to access support from our Provider Engagement team for any of our lines of business for which you are contracted. 
  • Trillium, Health Net and Wellcare  providers will also use the Provider Engagement team email box for Credentialing and Provider Rosters: Starting September 15, send your provider credentialing, rosters and roster updates to ORProviderExperience@TrilliumCHP.com. Your dedicated Provider Engagement Administrator will review your documents upon receipt to ensure accuracy of your requested updates before sending for processing. 
  • New email box for non-participating providers: We now have a dedicated email box to assist non-participating providers who serve our insured Trillium, Health Net and Wellcare members: ORNonParSupport@TrilliumCHP.com
  • Mail sent to old email boxes will be forwarded until October 15: To give you some time to transition to our new email boxes, any messages you send to the previous email boxes, including hnor_provideroperations@healthnet.com and tch_provideroperations@centene.com, will be forwarded to the new Provider Engagement team email box until October 15, 2025. Add our new centralized Provider Engagement team email box, ORProviderExperience@TrilliumCHP.com, to your contacts and start using it on September 15. It’s an easy way to reach your Provider Engagement team for all our lines of business!

What is staying the same?

Thank you for being a valued provider partner in serving Trillium, Health Net and Wellcare members!

______________________________________________________

Coming Up This Weekend: Developmental Disabilities Resource Fair

Trillium is proud to sponsor Washington County's Developmental Disabilities Resource Fair. Attendees will learn about available Developmental Disabilities (DD) services such as attendant care, relief care, behavior consultation, community recreation, educational resources, residential services, employment support, and more. This is also a great opportunity for networking among parents and caregivers.

In addition, DD supervisors and staff will be onsite to answer questions and share information about applying for DD services, with eligibility application support on site.

Please share this information with your staff, patients, and anyone who may find it helpful.

______________________________________________________

Adobe Population Health Services Available for Wellcare By Health Net and Wellcare By Trillium Advantage Members and Providers


Adobe Population Health started serving Wellcare by Health Net and Wellcare By Trillium Advantage members as of August 1, 2025. Adobe Population Health has many services available for you and your Wellcare Medicare patients, including in-home assessments.

Adobe Population Health will contact your Wellcare patients to schedule in-home assessments. These 45-minute health reviews with an Adobe Population Health provider include a check of the patient’s vital signs (if necessary), a medication review and a discussion of their medical history. The provider’s notes from this appointment will be sent to their primary care physician. You will also receive the credit for care gaps closed during the visit.

As a Wellcare network provider, Adobe Population Health’s services are free of charge to you and your Wellcare patients. We're pleased to offer this added level of care to support you and reduce your administrative burden.

To learn more, please review the Adobe Population Health flyer (PDF) or call Adobe Population Health Customer Service at 800-941-9270.

As always, your Wellcare By Health Net and Wellcare By Trillium Advantage Provider Engagement Representative is available to support you or answer any questions: