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Medicaid Providers

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Overview and Resources

WellCare 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.

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.

WellCare of Florida offers dedicated Provider Relations Representatives located in offices across Florida. 
Find your dedicated representative

 

Resources


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

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

WellCare offers robust technology options to save you time. The fastest ways to get what you need are shown in the Quick Reference Guide.

Partners in Care Together for Kids: Identification Tool for Providers

Online Tools for WellCare Providers

Staywell and Children’s Medical Services (CMS) health plan provide coverage for medically necessary durable medical equipment (DME) and medical supplies pursuant to the Statewide Medicaid Managed Care (SMMC) program.

Florida Medicaid Long Term Care plan provide coverage for medically necessary durable medical equipment (DME) and medical supplies pursuant to the Statewide Medicaid Managed Care (SMMC) program.

This letter is to notify you that effective 1/3/2021, we will begin applying coding edit guidelines for the appropriate coding of Evaluation and Management (E&M) code levels based on WellCare’s E&M Program.

Guidelines for submitting HEDIS Flat Files, ESD, and Active DX codes.

Florida WellCare Medicare, Staywell Medicaid,Children's Medical Services Health Plan Telehealth Provider Attestation

I attest that staff has received appropriate training in reporting abuse, neglect and exploitation (ANE) and will report knowledge or reasonable suspicion of these activities via the Florida abuse statewide toll free hotline

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

This reference guide provides a list of the departments at Staywell that may be helpful in assisting with coordination and authorization of services that a member may need as part of the discharge plan.

The following details all expanded benefits available to Staywell Medicaid members.

The following details all expanded benefits available to Staywell Medicaid members.

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

Children’s Medical Services (CMS) Health Plan is operated by WellCare of Florida, Inc., and understands that having access to the right tools can help you and your staff streamline day-to-day administrative tasks.

CMS Health Plan offers programs to help members access care and learn how to manage health conditions, including case management.

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This reference guide provides a list of the departments at Children’s Medical Services Health Plan (CMS Health Plan) that may be helpful in assisting with coordination and authorization of services that a member may need as part of the discharge plan.

This reference guide provides a list of the departments at Children’s Medical Services Health Plan (CMS Health Plan) that may be helpful in assisting with coordination and authorization of services that a member may need as part of the discharge plan.

WellCare covers Early Intervention Services and Child Health Services Targeted Case Management for members receiving services through the Early Steps Program.

Notice of New Inbound Edits for Florida Staywell Medicaid Claims and Encounters

Our partner for home health and durable medical equipment services.

WellCare streamlines the process of traditional provider contracting for MFC Parents.

Staywell reimburses approved providers for billing Long-Acting Reversible Contraception (LARC) devices on Fee-For-Service (FFS) claims.

Provider Name, Specialty and Hospital Privileges

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

ProgenyHealth Frequenetly Asked Questions

The Transition Age Youth Program is available to WellCare of Florida members over the age of 12 who have special health care needs, and who are enrolled in Staywell or Children’s Medical Services Health Plan.

Pediatric Therapy Issues?
Contact your local Provider Relations Representative:
By Phone: If you need help finding your representative’s information visit: Find My Representative
By Email: FloridaProviderRelations@wellcare.com

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Last Updated On: 6/23/2021