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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.

Electronic Health Records (EHR) Incentive Programs

CMS hosts regular webinars to educate providers on topics related to EHR Incentive Programs. If you use EHR, are interested in EHR capabilities, or want to learn how your practice can benefit, please visit the CMS website for more information.


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

ProgenyHealth Frequenetly Asked Questions

Medicaid Newsletters

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February 01, 2018

Issue I 2018 Provider Newsletter

Effective January 1, 2018 the Department of Community Health (DCH), Medicaid Division, will provide coverage for Autism Spectrum Disorders (ASD) services for individuals under the age of 21.

Doctors
May 01, 2018

Issue 2 2018 Provider Newsletter

Case Management helps members with special needs. It pairs a member with a case manager.

Claims Payment Policy image
October 02, 2017

Issue 3 2017 Provider Newsletter

You wanted a simpler, more efficient way to interact with us. We delivered. The new portal is now live and packed with features to help you care for your patients – our members – to ensure they have a positive health care experience.

Healthy Eating
December 01, 2017

Issue 4 2017 Provider Newsletter

Members put on anticoagulant medication are known to be at high risk for adverse events, specifically, bleeding. A study of emergency department (ED) visits for adverse events estimated that anticoagulants were associated with 17.6 percent of the visits, with 48.8 percent of cases resulting in hospitalization.1

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Last Updated On: 10/1/2018