Provider

Not a Participating Provider?
Thank you for your interest in our plan. WellCare understands that maintaining a healthy community starts with providing care to those who need it most. As the largest Medicaid and Medicare only contractor in the nation, we offer affordable healthcare plans to individuals eligible for government-sponsored programs.  To get started, complete the enrollment request form and WellCare of Ohio will contact you to become a participating provider.   

Participating Providers
Provider ID Number - The key to using our system is knowing your Provider ID number. This number is issued to each provider and can be found on your provider agreement and each Explanation of Payment (EOP) you receive from us.  Be sure to have your Provider ID number handy when calling WellCare. It allows faster access to our Interactive Voice Response (IVR) system and will aid our customer service representatives in responding to your inquiries more quickly.  If you don't know your Provider ID number, contact your local Provider Relations Representative or call Provider Services at 1 (800) 951-7719.

Latest News

5010 Implementation
The Administrative Simplification Provision of the Health Insurance Portability and Accountability Act (HIPAA) requires standards for electronic transactions, such as claims (including pharmacy), remittance, eligibility and claims status. The current versions of these standards, X12 Version 4010/4010A1 and NCPDP Version 5.1 will be replaced with Version 5010 and Version D.0, respectively. The federally mandated compliance date is January 1st, 2012, but in alignment with CMS’ grace period on enforcement action, WellCare will allow both 4010 and 5010 transactions to be submitted until June 30th, 2012. Click here for more information.

Important Changes in Electronic Data Interchange (EDI) Process - effective July 15, 2011
WellCare of Ohio accepts electronic claims only through RelayHealth, a division of McKesson.  If your vendor (i.e., practice management system, billing service or clearinghouse) is not connected to RelayHealth, we strongly encourage you to contact them directly and request that they establish this FREE connection. Upon confirmation from your vendor of continued electronic claims submission to WellCare via RelayHealth, no further action is necessary.  
If you have questions regarding submission of EDI transactions directly through RelayHealth, please see the provider notice and FAQs for more information, or refer to your Quick Reference Guides for contact information for providers and vendors.

Easy Access to Important Information
Click on the Resources tab above to access the wealth of information this website has available for our physician and provider partners or use the other tabs to access useful resources like claims, authorizations and eligibility information from the secure provider-only portion of this site.

Not Registered?
As part of WellCare of Ohio's network of providers, you can take advantage of a variety of services available on this site to manage your WellCare online account.  Your user name and password are required to access our secure provider only portal.

Register Today! Sign Up Here