Update to DRG Validation Program

Date: 06/09/26

Ambetter from WellCare of Kentucky is taking additional steps to verify the accuracy of payments made to our contracted facilities and will begin auditing selected claims and associated medical records on Aug. 2, 2026.

Ambetter from WellCare of Kentucky has contracted with Cotiviti to assist in ensuring payments are applied in accordance with national correct coding standards. If you have claims selected for audit, you will receive a letter from Cotiviti on behalf of Ambetter from WellCare of Kentucky requesting medical records to support the audit process.

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative.