Nebraska Providers

Welcome Providers

Healthy Blue combines national expertise with an experienced local staff to operate community-based health care plans.

We are dedicated to offering real solutions that improve health care access and quality for our members. Additionally, we are here to help you provide quality health care to our members.

On this site, you will find resources that help health care professionals do what they do best — care for our members.

Update Your Provider Information

Starting on January 1, 2021, WellCare of Nebraska will be operating on Healthy Blue systems, which will require providers to be enrolled with Healthy Blue and submitting claims in accordance with their Nebraska Medicaid enrollment profile. 

Failure to correct inaccurate information, or bill utilizing Medicaid enrollment profile data, will result in claim rejections as of January 1, 2021.  

Transitioning providers commonly need to update:
  • NPI
  • Taxonomy
  • Address including ZIP+4
  • Group affiliation
Please visit  Maximus to review your Medicaid enrollment profile to ensure all data is correct. 

Clinical Criteria

Effective January 1, 2021, WellCare of Nebraska, Inc. membership will transition to the Healthy Blue suite of clinical criteria. Please visit our Medical Policy and Clinical Utilization Management Guidelines subsidiary website to view the full list of criteria. In addition, we will use the American Society of Addiction Medicine® (ASAM) criteria for substance use services. Please note, Medicaid state contracts, regulatory guidance, CMS requirements and our Medical Policy/Clinical Utilization Management Guidelines supersede MCG Care Guidelines.

Availity Access

The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format, regardless of the payer. Registration is free!

Provider News

The latest articles and announcements on claims filing, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.