MLTSS time frames for claims processing WellCare is required to adjudicate (pay or deny) claims (for MLTSS members) for MLTSS services such as: assisted living providers, nursing facilities, special care nursing facilities, CRS providers, adult/pediatric medical day care providers, PCA and participant directed Vendor Fiscal/Employer Agent Financial Management Services (VF/EA FMS) claims within the following timeframes: 1.
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