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Getting Started

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Getting Started

You have or will receive a Welcome letter with your Provider ID or Network Identification number. The welcome letter includes the line(s) of business you are contracted with and effective dates.

Note: Keep your Provider ID handy. You will need it when registering for the secure Provider portal and for managing your business with WellCare.

When partnering with WellCare, you get:

  • We have dedicated staff to serve you in the communities you serve.
  • Prompt payments - Receive claims electronically and get quick payment of processed claims.
  • Quality improvement programs - The emphasis is on patient care.

Next Steps

Secure Provider Portal

The secure portal enables providers to check member eligibility, submit authorizations and claims, complete training, and more. Register for an account in just a few easy steps:

  1. Select: Medicare or Medicaid
  2. Enter Provider ID, Zip Code, and Tax ID.
  3. Complete a brief profile and accept HIPAA Terms and Conditions.
  4. Choose a username and select a security question.
  5. You will receive an email with a temporary password.
  6. Upon initial login, you will be prompted to reset your password.

Enjoy Faster Payments with Electronic Deposit

We encourage providers to enroll in PaySpan Health's EFT/ERA service to ensure faster payments.

Overview and Resources

We have assembled a set of resources to assist providers. View documents such as the Provider Manual, Quick Reference Guide and newsletters.

Clinical Guidelines

Clinical Coverage Guidelines
The Clinical Coverage Guidelines (CCG) are evidence-based documents detailing the medical necessity of given procedures or technologies. The guidelines set consistent criteria for the coverage of a procedure or technology, leading to greater consistency and efficiency in clinical decision making. This consistency and efficiency results in better provider/company interactions and increases the quality of our members' health.


Clinical Practice Guidelines
Clinical Practice Guidelines (CPG) are best-practice recommendations based on available clinical outcome and scientific evidence. WellCare Clinical Practice Guidelines reference expert professional and clinical society recommendations, ensuring that the guidelines contain the highest level of evidence-based content. Clinical Practice Guidelines are also used to guide efforts to improvement the quality of care in our membership.

 

  • Register for Self-Service

    Secure Provider Portal

    The secure portal enables providers to check member eligibility, submit authorizations and claims, complete training, and more. Register for an account in just a few easy steps:

    1. Select: Medicare or Medicaid
    2. Enter Provider ID, Zip Code, and Tax ID.
    3. Complete a brief profile and accept HIPAA Terms and Conditions.
    4. Choose a username and select a security question.
    5. You will receive an email with a temporary password.
    6. Upon initial login, you will be prompted to reset your password.
  • Enroll in EFT/ERA

    Enjoy Faster Payments with Electronic Deposit

    We encourage providers to enroll in PaySpan Health's EFT/ERA service to ensure faster payments.

  • Access Key Resources

    Overview and Resources

    We have assembled a set of resources to assist providers. View documents such as the Provider Manual, Quick Reference Guide and newsletters.

  • View Clinical Guidelines

    Clinical Guidelines

    Clinical Coverage Guidelines
    The Clinical Coverage Guidelines (CCG) are evidence-based documents detailing the medical necessity of given procedures or technologies. The guidelines set consistent criteria for the coverage of a procedure or technology, leading to greater consistency and efficiency in clinical decision making. This consistency and efficiency results in better provider/company interactions and increases the quality of our members' health.


    Clinical Practice Guidelines
    Clinical Practice Guidelines (CPG) are best-practice recommendations based on available clinical outcome and scientific evidence. WellCare Clinical Practice Guidelines reference expert professional and clinical society recommendations, ensuring that the guidelines contain the highest level of evidence-based content. Clinical Practice Guidelines are also used to guide efforts to improvement the quality of care in our membership.

     

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Last Updated On: 4/13/2021