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Overview & Resources

WellCare of Georgia partners with providers to develop and deliver high-quality, cost-effective health care solutions. We understand that maintaining a healthy community starts with providing care to those who need it most. We are committed to improving the quality of life of our millions of members, who often include some of our nation's most vulnerable populations.

Important Benefit Information

WellCare provides certain benefits and services specified by federal requirements for health plans administering to Medicaid members.

Medical Expense Initiative

In 2016, edits will be derived directly from the state and national Medicaid editing guidelines. This will save money on vendor fees and additional costs each year. To learn more, please review the National and State-level Medicaid rules.

Resources


Get detailed health plan information on important topics such as coverage procedures and policies.

Contains key phone numbers and information on claims, appeals and more.

Details the various tools available to help providers do business with us.

How to quickly get in touch with WellCare to get your questions answered.

How to quickly get in touch with WellCare to get your questions answered.

Find the name and phone numbers of your provider relations representative.

Find the Hospital Services Specialist assignments in this network.

PCP Appointment Scheduling Guidelines

Specialist Appointment Scheduling Guidelines

Behavioral Health Appointment Scheduling Guidelines

Instructions for large groups and IPAs with five or more providers on how to register for the secure provider portal.

News & Events

Healthy Eating
March 17, 2016

Issue I 2016 Provider Newsletter

In early 2016, WellCare will conduct the annual Provider Satisfaction Survey to continue measuring progress, as well as better evaluate how we can become more effective and productive business partners.

WellCare Provider Newsletter disease management image
June 17, 2016

Issue II 2016 Newsletter

WellCare conducts a quarterly medical record audit to measure the effectiveness of EPSDT screenings for both PeachCare for Kids (birth to 19 years of age) and Medicaid members (birth to 21 years of age).

Balance Billing image
January 14, 2016

Issue IV 2015 Newsletter

WellCare will have a new Pharmacy Benefit Manager (PBM) in 2016, CVS Caremark. Members will receive new ID cards with updated processing information.

Claims Payment Policy image
November 30, 2015

Issue III 2015 Newsletter

The Healthy Behaviors Program rewards members for taking small steps that will help them live healthy lives. For simple tasks like completing PCP visits, prenatal visits, and certain health checkups, members can earn rewards which are placed on reloadable Visa® cards.

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Last Updated On: 3/23/2016