We recognize that, at times, the administrative requirements of managing your patients' health care can be complex. The Provider Manual is a source to use for questions about health plan coverage procedures, policies and other facts related to your provision of health care services to our members.
 
  Table of Contents
  Section 1 - All About WellCare
  Section 2 - Provider Responsibilities & Guidelines
  Section 3 - Member Eligibility
  Section 4 - Inpatient Concurrent Review
  Section 5 - Utilization Management
  Section 6 - Pharmacy Overview
  Section 7 - Claims Overview
  Section 8 - Complaints, Grievances and Appeals
  Section 9 - Credentialing Overview
  Section 10 - Risk Management
  Section 11 - Quality Improvement
  Section 12 - Case Management
  Section 13 - Behavioral Health
  Section 14 - Marketing Guidelines
  Section 15 - Delegated Services
  Section 16 - Administrative Policies 
     Section 17 - Forms