Provider : Texas Medicare Provider Manual

This manual is for Coordinated Care Plans (CCP) only. For questions regarding Private Fee-For-Service (PFFS), call 1-866-235-2770.

2011 Medicare Compliance Addendum

Note to Provider

Table of Contents

Section 1    All About WellCare

Section 2    Provider Responsibilities

Section 3    Member Services

Section 4    Utilization Management

Section 5    Pharmacy

Section 6    Claims

Section 7    Appeals and Grievances

Section 8    Credentialing

Section 9    Risk Management

Section 10   Quality Improvement

Section 11   Medical Records

Section 12   Case Management

Section 13   Behavioral Health

Section 14   Cultural Competency

Section 14   Dual Eligible Members

Section 15   Provider Education Materials

Section 16   Forms

                  Quick Reference Guide

                  Quick Reference - Auth Required CPT Code Lists

Addendum   TX Payment for Dual Eligible Members Addendum