Dear Provider,

Thank you for you for attending the WellCare Provider Summit.  We hope the forum discussions addressed most of your questions about Managed Care and allowed you to share your challenges, as we work to find solutions - together.   

We appreciate the open conversation had during our meeting and we are committed to finding answers to your questions.  Attached you will find responses to most of the questions submitted to us at the forums. In addition, we have included some of the most common questions below. 

When or how do I obtain an authorization? – The Quick Reference Guide will show you which procedures need prior approval, how to place a request and lists contact information for the most frequently used WellCare departments. 

Where do I find my WellCare Provider ID number? Your WellCare Provider ID number is listed on the contract packet sent to you when you became a network provider. It is also found on every Explanation of Payment (EOP) sent to you from WellCare. Your Provider Relations Representative can also assist you in finding your WellCare Provider ID. 

How can I reach my Provider Rep? – Call our Provider Hotline at 1-866-231-1821, our agents will be more than happy to assist you. 

How do I find a copy of WellCare’s Preferred Drug List? – Download a copy from the Pharmacy Services page of this Web site or request one from your Provider Relations Representative. 

How do I submit a claim? – The most practical and time efficient method is via electronic submission. Refer to the “Tips on How to File Claims” document posted on the Forms and Documents page of this website (your Provider Rep. can also furnish a copy) to get clearinghouse and payor ID information, as well as steps to guide you in the process. Paper claims are also accepted under specific formats. The “Tips on How to File Claims” guide also contains this information. 

What is the advantage of registering on your website? – Many functions are automated for your convenience. At any time you may:

·         Check member eligibility and co-pay information
·         Submit an authorization request for planned services
·         Create pharmacy usage reports
·         Find the most updated copy of the Provider and Hospital handbooks
·         Submit claims, monitor their status and create reports 

WellCare is delighted to be in partnership with you in creating a healthier Georgia community. For more in-depth information, feel free to contact your Provider Relations Representative or our Provider Hotline at 1-866-231-1821.

Thank you,
WellCare of Georgia