A repository of Medicare forms and documents for WellCare providers, covering topics such as authorizations, claims and behavioral health.

Requirements: Clinical information and supportive documentation should consist of current physician orders, notes and recent diagnostics. Notification is ...

Please type or print in black ink and submit this request to the fax number above. MEMBER INFORMATION. WellCare ID : Last Name: First Name, MI: Medicaid/ ...

Access key forms for authorizations, claims, pharmacy and more. Ancillary Contract Packet If you provide services such as home health, Personal care services, ...

Requirements: Clinical information and supportive documentation should consist of current physician order, notes and recent diagnostics. Notification is ...

Authorization Forms. Medicare Outpatient Authorization (PDF) - last updated Dec 16, 2022; Medicare Inpatient Authorization (PDF) - last updated Dec 16, 2022 ...

The purpose of a WellCare prior authorization form is to provide documentation that a given service or medication is medically necessary, and to obtain ...

Wellcare has partnered with CoverMyMeds to offer electronic prior authorization (ePA) services. Select the appropriate Wellcare form to get started.

Please read the instructions carefully and complete the form below. Incomplete forms cannot be accepted. Member Information: Member Name (print): Member Date of ...

To verify if a service requires prior authorization use the “Pre-Auth Needed” tool below or call our utilization management department at 1-833-925-2861 with ...