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Overview & Resources

Wellcare By ‘Ohana Health Plan 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.

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.

This guide explains the services that Wellcare offers to help you and your staff streamline day-to-day administrative tasks.

Guide to using online tools for Wellcare By ‘Ohana Health Plan Providers

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

The secure Provider Portal is your best, fastest and most reliable way to submit an Authorization Request. It lets you skip the fax machine and get your request directly to the clinical team for processing.

A STAR score is a rating system used by Center for Medicare and Medicaid Services (CMS) to measure how well healthcare plans perform in categories such as quality of care and customer service. Ratings range from 1 STAR (poorest quality) to 5 STARS (highest quality).

Medicare Provider/Facility Tip Sheets

Follow-Up After Emergency Department Visit For People With High-Risk Multiple Chronic Conditions (FMC)

Hospitalization for Potentially Preventable Complications (HPC)

Follow-Up After Emergency Department Visit For People With High-Risk Multiple Chronic Conditions (FMC) Medicare Beneficiaries

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Y0020_WCM_87476E Last Updated On: 6/9/2022