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Provider : Resources


The following resources are available to assist providers. Materials may change occasionally so please check back to ensure you have the most current version.  


Authorization Look-Up Tool
Available for most lines of business. Search quickly and easily by CPT code.


Provider Manuals
Detailed health plan information on important topics such as coverage procedures and policies.


Quick Reference Guides
Contains key phone numbers, authorization requirements and more.


Forms and Documents
Key forms for appeals, authorizations, claims, pharmacy services and more:  



Behavioral Health

Information about our behavioral health program, including authorization requirements, case and disease management and more.


Claims Updates
Get updates on WellCare's processes to ensure your claims are handled efficiently.


Clinical Coverage Guidelines
Evidence-based guidelines detailing medical necessity of procedures or technologies. Note: Please check the Position Statement in each CCG to determine coverage determination for your state/market.


Clinical Practice Guidelines
Best-practice recommendations based on available clinical outcome and scientific evidence. 

Coordination of Benefits
Coordination of Benefits (COB) claims are essential to adjudicating claims correctly. WellCare encourages providers to submit COB claims electronically

WellCare is pleased to offer providers electronic funds transfer (EFT) and electronic remittance advice (ERA) services at no charge.


ICD-10 Compliance
WellCare will be compliant with the CMS rule for ICD-10 readiness beginning October 1, 2015. We have compiled important information and Frequently Asked Questions for providers.



Job Aids and Resource Guides
Your one-stop shop for resource documents and instructions on how to perform daily tasks.

Get recent information about pharmaceuticals, cost, quality of care and more.


Training and Education
Access a variety of educational materials designed to help providers meet training requirements.


All links associated in the section above require the ability to open .pdf files. If for any reason you are not able to view these links, please download the reader software.

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Last modified: 04/13/2015

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