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Overview & Resources

WellCare of New Jersey 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.

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

Effective 1/26/2021, 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.

Guide to using self-service features in the provider portal.

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

Quality care is a team effort. Thank you for playing a starring role!

Wellcare Hearing Plan

Wellcare Vision Plan

Wellcare Gold Dental Plan

Wellcare Silver Dental Plan

Wellcare Bronze Dental Plan

Wellcare Copper Dental Plan

Wellcare Platinum Dental Plan

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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Last Updated On: 12/4/2020
Medicare Members: Your materials are on the way! We realize you may be waiting to receive some plan materials and we apologize for any delays. Did you know you can go online to our member portal to view Member materials, review your benefits, request or download an ID card, or choose a physician (when applicable)? Log in or register today!
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