What is Continuity of Care?
Yes. The Continuity of Care period covers all members who are transitioning to WellCare, and all providers who are rendering services upon transition. Our Network Development team will continue to work with you to ensure you complete the credentialing and contracting process as quickly as possible. If you have questions on credentialing or the status of your contract, please contact your local Network Contract Manager.
Continuity of Care refers to the period during which WellCare honors all services previously authorized for members who are transitioning to us from another Florida Medicaid health plan, or the fee-for-service delivery system.
How Long is the Continuity of Care Period?
Florida Medicaid’s standard Continuity of Care period is 60 days. However, effective December 1, 2018 WellCare will increase this to 120 days. The goal is to give providers plenty of time to finalize becoming part of the WellCare provider network, and to obtain new authorizations for services (if necessary) without disrupting member’s care.
How Does WellCare Know these Services Were Previously Authorized?
WellCare uses information provided by other health plans and the state to indicate whether a member previously received services. Providers should contact us during the Continuity of Care period to discuss the member’s needs, and to notify us of previous services at 1-866-334-7927.
I am not Part of WellCare’s Network Yet, How Will I be Paid?
During the Continuity of Care period, WellCare will pay for all previously authorized services whether the provider is contracted with us or not. Providers do not need a WellCare authorization number during this time. Providers must submit a clean claim. If you have questions about how to submit a claim, please contact your Provider Relations representative. If you don’t know who your Provider Relations representative is, you may contact FloridaProviderRelations@wellcare.com or call 1-407-551-3200, option 2.
How Do I Submit a Claim?
Providers who are still in the contracting process can submit a claim through any available mode except the provider portal. Providers who have completed the contracting process and are part of the WellCare Network can submit claims through any available mode. Please reference the attached Provider Resource Guide. Claims submission instructions begin on page 4 through page 7.
Yes. The Continuity of Care period covers all members who are transitioning to WellCare, and all providers who are rendering services upon transition. Our Network Development team will continue to work with you to ensure you complete the credentialing and contracting process as quickly as possible. If you have questions on credentialing or the status of your contract, please contact your local Network Contract Manager.
I Have Questions About Becoming a Network Provider, Submitting Claims, and Navigating WellCare’s Systems. Who Do I Contact? Please contact your Provider Relations representative. If you don’t know who your Provider Relations representative is, you may contact FloridaProviderRelations@wellcare.com or call 1-407-551-3200, option 2.
