The Centers for Medicare & Medicaid Services (CMS) regulations require that health plans provide their Special Needs Plan provider network with information on their basic Model of Care. This applies to our Dual-Eligible Special Needs Plan (D-SNP) members who are eligible for both Medicare and Medicaid, and Chronic Needs members (C-SNP), who have one or more qualifying conditions.
Please review WellCare's self-study program that outlines the basic Model of Care requirements for our providers. Frequently asked questions outline other information you may find helpful.
Medicare Provider Expectations - Model of CareWellCare asks that you partner with us to ensure we are giving the highest quality of care possible to our SNP members by performing the following steps:
1. Review the member Care Plans faxed to you by a WellCare Case Manager.
2. If necessary, update the Care Plan with any required changes and fax the revised plan back to WellCare at 1-866-287-3286.
- Call 1-866-635-7045 for questions or to further discuss the Care Plan; or you can call the Case Manager directly at the phone number listed on the fax cover sheet of the Care Plan.
- Please keep a copy of the updated Care Plan to review with the SNP member during their next office visit.
3. Participate in Interdisciplinary Care Team (ICT) for all SNP members and give feedback as appropriate.
We appreciate the quality care you provide our members and your support in our efforts to meet the CMS regulations regarding the Special Needs Plan Model of Care.