As a provider, you have access to a portal that streamlines your work, keeps you up-to-date more than ever before and provides critical information. Once you register and have access to the Wellcare provider portal, you will find a variety of video training available in the Resources section of the portal. The Wellcare provider portal offers secure access to variety of tools that will make it easier to do business with them and also:
- Submit Authorizations and Claims
- View Authorization and Claim Status
- View Member Profiles, including:
- Eligibility and Benefits
- Recent Authorizations
- Recent Claims
- Care Gaps
- Visit History
- Pharmacy Utilization
- Secure Messaging with WellCare
- Chat online with Customer Service agents, and more.
You have to attentively read this article till the end in order to learn how to register for Wellcare Provider Portal online access, learn how to sign in and manage your account on the Wellcare Provider Portal. Keep in mind, though, that like this website, it only gives general information for everyone. It is not the law. It is not a regulation. It is not legal advice.
How To Sign Up for the Wellcare Provider Portal
Learn how to sign up to access the Wellcare secure provider portal. You no longer need multiple accounts for different locations. Create one account and Wellcare will affiliate you to your multiple locations! Once you submit your registration, you will receive a system email with a link asking you to verify your account and create your password. If you do not receive the password validation email, please check your Spam inbox.
To Sign Up for the Wellcare Provider Portal go to https://provider.wellcare.com/Provider/Accounts/Registration and complete the registration. Be sure to stick to the Username Requirements below.
- Must be between 8 and 12 in length.
- Will only contain letters (a-z or A-Z), numbers (0-9), and/or underscore (_).
- Must contain at least one letter and one number.
- Must start with a letter.
- Cannot be a duplicate.
How To Log In To Wellcare Provider Portal
If you have a Wellcare Provider online account, you may access it at any time. It’s simple to go into your online account, and you’ll need your login information. To log into your online account, follow these simple steps:
Step 1: Go the Wellcare Provider Portal Login page: https://provider.wellcare.com/provider/login
Step 2: Upon reaching the login page, provide your username and password in the blank spaces below and then press “Sign In”. If the particulars entered are correct you will also be taken to your account dashboard. *NOTE: The secure provider portal is for participating Wellcare providers only.
Wellcare Provider Portal Frequently Asked Questions
1: How can I tell if a member is enrolled in a special program? Special Programs are also known as CM/DM. Members who are enrolled in special programs will have extra information on their member details page that identifies the program(s) they are enrolled in.
2: How do I submit a medical authorization? To check whether an authorization is needed, complete the minimum amount of information needed for validation and submit: Member ID – select the member first and the member information is pre-populated into the authorization form; Provider ID – the requesting provider information is pre-populated into the form based on their login information; Place of Service; Number of Visits and CPT code(s). An authorization can be submitted up to 30 days prior to the service date. Note: If you are submitting an authorization for one of the following, you will be directed to their website to complete the authorization: eviCore, eviti, CMPCN and Georgia State website.
3: How can I manage User Accounts? Access requests are located on the My Practice page. You must have administrator authority to grant users access and permissions for your location.
4: I forgot my Password, what can I do? Users are able to reset and then change password by providing their Username, Answer to security questions, and Email address associated with registered account. If you encounter an error while resetting your password, please contact customer service. You can find the customer service number by selecting State and Plan in the Help section.
5: What types of communication is available in the secure messaging inbox? Your secure messaging inbox is designed for communicating with colleagues as well as sending and receiving messages from WellCare. You can perform these actions from your inbox: Receive and reply to messages, View and open messages, Create and send messages and Download and print attachments from message.
7: Where can I view reports? Reports are located in the Reports Center under the My Practice heading. You can view these reports: Active Members, Inpatient (Hospital) Log, Care Gaps, Members Overdue for Screening (EPSDT), Member EPSDT Visit History and Members Admitted/Registered as Inpatient.
8: How do I appeal a denied authorization? To appeal an authorization in Denied status, search for the authorization using one of these criteria: Member/Subscriber ID, Provider ID, Patient Name and Date of Birth, Medicare ID or Medicaid ID. Search results will display based on date of service. Select Authorization Appeal from the drop down. Fields will be pre-populated from the original authorization request. Attach supporting documentation as necessary. Note: For the Medicaid lines of business, an appeal cannot be submitted unless the member consent checkbox is selected.
9: How do I submit a professional claim? Electronic claims submissions provide real-time status updates, allow you to include authorizations and attach additional documentation as necessary as well as pre-populating member and provider information. To begin a Professional Claim Submission select a member and the member information will be pre-populated or manually enter the information in a blank form. Complete the required fields. Attach up to a maximum of 10 documents. The system will perform field level validation when you submit the claim.
10: How do I check claim status? View claim status at any phase during the process, including Denied with denial reason. To check claims status, begin by searching for one or multiple claims. You can lookup claims using either the WellCare Control Number (WCN), Claim Number, Medicaid ID, Medicare ID, Member ID or Member Name and Date of Birth.
11: How do I correct a claim? Correct a claim by performing a search for one or multiple claims. To correct the claim click on the Select Action drop down then select Correct Claim. Fields from the original claim are pre-populated and editable except for the member and provider IDs.
Wellcare Contact Information
Do You Have a Question, Comment or Suggestion? If so, they want to hear from you.
General Mailing Address
Wellcare Health Plans
P.O. Box 31370
Tampa, FL 33631
Please address legal matters to the Plan at:
ATTN: Legal Department
7700 Forsyth Boulevard
St. Louis, MO 63105
Please address lien and subrogation requests to the Plan at:
The Rawlings Company
Post Office Box 2000
La Grange, KY 40031