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Provider Manual
We recognize that, at times, the administrative requirements of managing your patients' health care can be complex. The Provider Manual is a source of answers to questions you may have about health plan coverage procedures, policies and other facts related to your provision of health care services to our members.

 

Welcome Letter

 

Table of Contents

Section 1

All About WellCare

Section 2

Physician Responsibilities

Section 3

Member Services

Section 4

Utilization Management

Section 5

Pharmacy

Section 6

Claims

Section 7

Appeals & Grievances

Section 8

Credentialing

Section 9

Risk Management

Section 10

Quality Improvement

Section 11

Medical Records

Section 12

Case Management

Section 13

Cultural Competency

Section 14

Behavioral Health

Section 15

Quick Reference Guide

Section 16

Provider Education Materials

Section 17

Forms

  AddendaOH Medicaid Provider Manual Section 6 Claims HIPAA-SNIP Changes Addendum    

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