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Medicaid Providers

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Forms

Access key forms for authorizations, claims, pharmacy and more.

Administrative Review

Members can use this form to request a new Primary Care Provider (PCP).

Authorizations

Hospice Prior Authorization Request Form

Surgery Prior Authorization Form

Please include additional procedures codes, as applicable, in the Clinical Summary

Behavioral Health

A fillable form documenting behavioral health areas of specialization

Since the questionnaire relies on patient self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient.

Georgia Medicaid Behavioral Health Service Request Form: Routine Outpatient Services

Billing Guidelines

Brochures

Claims

Cultural Competency

How To Guides

Member Services

In order to begin the program, members will need to have you complete this form.

Complete this form after the member completes the 6-month Weight Watchers program.

Pharmacy Services

Drug Prior Authorization Requests Supplied by the Physician/Facility

Telemedicine

Turning Point Materials

Turning Point 2021 AEP FAQ

Other Forms


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Last Updated On: 5/3/2021
WellCare will be performing maintenance on Saturday, October 16, 2021 at 6pm EST until Sunday, October 17, 2021 at 6am EST. You might not be able to access systems or fax during this time. We are sorry for any issues this may cause. Thank you for your patience. If you need assistance, contact us. ×