Ohana

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Claims Submission

ʽOhana Health Plan, Inc.
Claims Department
P.O. Box 31372
Tampa, FL 33631-3372

Claim Rejections

Send an email with the WCN#, Tax ID, date of service, and NPI to:
edi-master@wellcare.com

Current Payouts

90791 $104.43
90837 $110.09

Notes

  • Ohana can connect you to receive electronic deposits through Payspan for no fee. Ohana does not provide free electronic claims submissions. You must submit claims via the CMS-1500 form.
  • Ohana does not return incorrect/rejected CMS-1500 forms, just a letter stating the problem with the claim.

Authorization for out-of-network clients

File:Ohana_Out_of_Network_Authorization_Form.pdf

  • You must write the "number of units requested" (the number of sessions requested) in the blank space on the bottom, because for whatever reason Ohana didn't put a space for it on the form.

Intelliride Authorization Form

File:Ohana_Intelliride.pdf

  • This form does not include a standing order. Client will need to call in advance to schedule rides.