Carolina Complete Health has identified an issue affecting provider access to the WellCare Secure Provider Portal following the merger. Practices that previously held only a WellCare of North Carolina Medicaid contract—and no other WellCare contracts—may currently be unable to log in.
This issue has been escalated due to its impact on historical claims activity. A fix has been identified and was deployed April 3, 2026. Once deployed, providers should again be able to access the WellCare Secure Provider Portal to submit and review claims with dates of service prior to April 1, 2026.
It is important to note that while claims access is expected to be restored, some wraparound functions (including consent forms and the claim reimbursement calculator) will not yet be available as work continues to fully restore portal functionality.
Additional details are available here.
While portal access is being restored, providers can continue submitting Medicaid claims with dates of service prior to April 1, 2026 through existing electronic pathways. Claims may be submitted via Availity Essentials by selecting WellCare of North Carolina as the payer, or by EDI using WellCare Payer ID 14163.
Once portal access is fully restored, the WellCare Secure Provider Portal will again be available for historical claims submission and review.
Claim submission for services provided on or after April 1, 2026 is not impacted by the portal issue. Providers should continue submitting these claims to Carolina Complete Health using their established workflows, including the Carolina Complete Health Secure Portal, Availity Essentials (selecting Carolina Complete Health as the payer), or EDI using Payer ID 68069.
An update is also available regarding WellCare claim reprocessing related to the rate rebase reversal. WellCare did not meet NC DHHS-established timelines for completion, but the claims team is providing regular progress updates.
To date, over 508,146 claims have been adjusted and moved to payment, with the remaining claims continuing to be processed daily. The team is currently on track to complete reprocessing by April 30, inclusive of all North Carolina tickets received year to date, with remaining activity tracking through April. Any changes to this timeline will be shared as soon as they are known.
Carolina Complete Health has also revised its guidance on antepartum billing and coding following a clarification request. Under North Carolina Medicaid Clinical Coverage Policy, CPT code 59426 must be billed using the date of delivery as the date of service.
As a result, if the delivery date occurred prior to April 1, 2026, the claim should be billed to WellCare, even when antepartum visits span the merger date. Practices may be advised that antepartum care beginning before April 1 should continue to be billed to WellCare, even if some visits took place after April 1.