Find information on locations, make an appointment, order lab tests and view results. Contact Us Find a Provider or Clinic Learn about WellMed's Network of Doctors Find out how WellMed supports the community Learn more about WellMed Our Health and Wellness Services Your care team MondayFriday, 8 a.m. to 5 p.m. (ET). Disease management: Providing education and support to help you better manage chronic conditions. We are happy to help. 0 2023 WellMed Medical Management Inc. All Rights Reserved. Questions or comments. You will receive a decision in writing within 60 calendar days from the date we receive your appeal. Dallas, TX 75265-0287. Cypress, CA 90630. Kentucky Medicaid: 800-444-9137. A digital tool that provides an all-in-one record of an individuals health, enabling a person and their care team to help improve collaboration and care. Suite 1750 Box 30508 Worksite Wellness Health Screening WellMed members WellMed requires a referral from the assigned PCP before rendering services for selected specialty care providers. Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Utilize Risk Adjustment Processing System (RAPS) tools Phone: 1-877-670-8432 ), or M.B.B.S; Board certification or eligibility in Family or Internal Medicine WellMed has more than 22,000+ primary care physicians, hospitalists, specialists, and advanced practice clinicians who excel in caring for 900,000+ older adults across Texas and Florida. 0000005057 00000 n Hours of operation: 8 a.m to 7 p.m. Eastern time, Monday through Friday. Find patient care and support information. Please contact our Patient Advocate team today. Find Caregiver Resources (Opens in new window). Eligibility and benefits interactive guide Phone: 1-800-819-0751 0000004384 00000 n P.O. Verify pharmacy benefits and eligibility, adjudications, or authorizations. We can also help schedule appointments with your doctor. wellmedhealthcare.com/the-joint-commission, MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. This page outlines the basic steps to prepare a practice to deliver telehealth, offers tips and best practices and suggests tools to measure telehealths effectiveness for the practice population. Updating Provider Directory Information Contact us with changes to your phone number, office address, or panel status. Email: WebsiteContactUs@wellmed.net Founded in 1990, they started off as one clinic in Texas and quickly grew across Texas and Florida. Individual Health Record (IHR) Licensed clinicians are on call 24 hours a day, 7 days a week. View and submit authorizations and referrals 0000001429 00000 n Denise Malecki: denise.malecki@amerigroup.com. Phone: 1-888-774-7772 0000010612 00000 n Located inside WellMed at Great Northwest Please contact our Patient Advocate team today. For current HSA, FSA and HRA account holders, find support at the link below or call us today. 0000008118 00000 n Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Check claims, eligibility, benefits. Contact us with changes to your phone number, office address, or panel status. Medicare: 0000003369 00000 n 2023 WellMed Medical Management Inc. All Rights Reserved. You make a difference in your patient's healthcare. <<1283B0ACEBB5B2110A00B0933B5DFE7F>]/Prev 373885>> 800-822-5353 Vision UnitedHealthcare March Vision Care 877-627-2456 Spectera 800-638-3120 Physical health 800-873-4575 or 866-427-6845 State-specific health plan and network support Select your state to find information, service and support. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. Box 30448 Call: 1-888-781-WELL (9355) Find Caregiver Resources (Opens in new window). 13725 Northwest Blvd. Authorizations and Notifications. 8353 Culebra Road, Ste. Interested in learning more about WellMed? Obtain information on electronic claims submission. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. View claims status Telehealth eProvider Resource Gateway "ePRG", where patient management tools are a click away. 866-273-9444. Denials with solutions in Medical Billing, Denials Management Causes of denials and solution in medical billing, CO 4 Denial Code The procedure code is inconsistent with the modifier used or a required modifier is missing, CO 5 Denial Code The Procedure code/Bill Type is inconsistent with the Place of Service, CO 6 Denial Code The Procedure/revenue code is inconsistent with the patients age, CO 7 Denial Code The Procedure/revenue code is inconsistent with the patients gender, CO 15 Denial Code The authorization number is missing, invalid, or does not apply to the billed services or provider, CO 17 Denial Code Requested information was not provided or was insufficient/incomplete, CO 19 Denial Code This is a work-related injury/illness and thus the liability of the Workers Compensation Carrier, CO 23 Denial Code The impact of prior payer(s) adjudication including payments and/or adjustments, CO 31 Denial Code- Patient cannot be identified as our insured, CO 119 Denial Code Benefit maximum for this time period or occurrence has been reached or exhausted, Molina Healthcare Phone Number claims address of Medicare and Medicaid, Healthfirst Customer Service-Health First Provider Phone Number-Address and Timely Filing Limit, Kaiser Permanente Phone Number Claims address and Timely Filing Limit, Amerihealth Caritas Phone Number, Payer ID and Claim address, ICD 10 Code for Sepsis Severe Sepsis and Septic shock with examples, Anthem Blue Cross Blue Shield Timely filing limit BCBS TFL List, Workers Compensation Insurances List of United States, Workers Compensation time limit for filing Claim and reporting in United States. Phone: 1-855-575-0293 73 0 obj 0000000016 00000 n Provider Portal (ePRG) (Opens in new window) Physician/Provider Opportunities . 2130 Culebra Rd. Eligibility and Benefits Verifications. Medicaid customer service. Suite 1250 Our extensive support team enables you to actually focus on being a doctor and having time to truly care for each patient. Member Services available 24 hours. Required Qualifications: Doctor of Medicine (M.D. Email questions or comments to Network Management Services (NMS) atPCP-NetworkManagementServices@uhcsouthflorida.com, or send mail to: Preferred Care Partners Network Management Services For Medicare and Retirement Prescription Drug Plans (PDP): Preferred Care Partners, Inc. For general inquires, call our subrogation department. Phone:1-877-670-8432 The program is intended to improve quality and value in cancer care by supporting the use of therapies supported by evidence-based guidelines to improve outcomes. San Antonio, Texas 78251, Medicare Information Center brought to you by WellMed 0000033577 00000 n Verify patient eligibility, effective date of coverage and benefits Medication management: Help with medication refills and reminders to fill prescriptions. Submit referrals to Disease Management 9100 South Dadeland Blvd. Submit claims electronically to Payer ID WELM2. Call the number on the back of your membership card or call the corporate switchboard, Monday through Friday, at 1-888-445-8745. Submit or update credentialing, re-credentialing, document changes, or recent hires or terminations in your practice or facility. Ask questions regarding your Agreement, in-servicing and follow-up or outreaches. If you are a patient and have medical concerns, please do not use this form. Callor visit the Live and Work Well website. Interested in learning more about WellMed? The UnitedHealthcare Dental Provider Portal helps providers get access to more patients, competitive reimbursement rates and dedicated support. Only available under certain plans. Find Caregiver Resources (Opens in new window). Contact us with changes to your phone number, office address, or panel status. Prior to Appointment Corpus Christi, Texas 78405, Medicare Information Center brought to you by WellMed MondayFriday, 9 a.m. 5 p.m. (ET). For information about filing a grievance or appeal on behalf of a member, status inquiries, or requests for forms. MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. MondayFriday, 9 a.m. 5 p.m. (ET). Dallas, Texas 75237, Medicare Information Center brought to you by WellMed Interested in learning more about WellMed? 2023 UnitedHealthcare | All Rights Reserved, Eligibility and Benefits Resources for Providers, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources, Eligibility and benefits interactive guide, Maternity Support for UnitedHealthcare Community Plan Members. For password help, registration issues, or other general assistance with our website, please call us at (888) 781-9355 (TTY 711). Located inside HEB a health care provider, hospital or WellMed. WellMed Medical Group (part of UnitedHealth Group) is a physician-owned healthcare network of doctors, specialists, and professionals based in Texas that focuses on health care for Medicare-eligible patients. OptumRx Maternity Support for UnitedHealthcare Community Plan Members Welcome to the newly redesigned WellMed Provider Portal, eProvider Resource Gateway "ePRG", where patient management tools are a click away. Now you can quickly and effectively: Mailing Addresses General Mailing Address Wellcare Health Plans P.O. 2023 WellMed Medical Management Inc. All Rights Reserved. Why Choose WellMed? Email: WebsiteContactUs@wellmed.net For additional questions call us at 1-877-670-8432 or email us at NetworkManagementServices@uhcsouthflorida.com. Interested in learning more about WellMed? Buddy Castellano: buddy.castellano@anthem.com Box 6106 Available 24 hours a day, 7 days a week. 0000005482 00000 n Box 400066 Access a list of behavioral health care providers in the provider directory. 0000006009 00000 n Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. 0000007129 00000 n Today our greatest saturation is in Texas and Florida with opportunities for providers in small towns to large metroplexes to desert destinations and beachfront locales. If you need assistance using our website or mobile application, or assistance with a document on the website or application, we can help you. 0000008977 00000 n Speak to a nurse to triage emergency or urgent care, or to refer them to their primary care physician. Contact MedCare to arrange for these services. Louisiana Medicaid: 800-448-3810. 5042 South Padre Island Dr. Use Payer ID 65088. Claims (WellMed) 800-550-7691. 41 0 obj hb```b``f`e`Qdf@ a+>Oss=(J4 kUpSY\_jAl.qnY4jQH@::@A!0mllM\\. MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. 9100 South Dadeland Blvd. Located inside Doris Griffin Senior One Stop <>stream 0000013868 00000 n Salt Lake City, UT 84130-0448. Box 31370 Tampa, FL 33631 Please address legal matters to the Plan at: ATTN: Legal Department Centene Plaza 7700 Forsyth Boulevard St. Louis, MO 63105 1301 E. Fern Ave. Suite C1 Determine if a plan requires prior authorization or notifications or referrals, download digital ID cards and find any additional coverage available. Email: WebsiteContactUs@wellmed.net WellCare has implemented a process of reviewing and adjusting claims payments for inpatient admissions that are deemed to be a readmission. 1-800-496-5841 iSNP. eviCore Headquarters 400 Buckwalter Place Blvd. If you are looking for pharmacy services,contact Optum Rx sales. Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Please remember to check the member's updated ID card. Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Cypress, CA 90630. South Carolina Medicaid: 866-432-0001. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. Phone: 1-877 -757 4440 Other Services That May Require PA . Representatives are available Monday through Friday, 8:00am to 5:00pm CST. Provider Bulletins The latest updates and information for providers. Box 650287 To submit a New Case Referral or Request for Case Information electronically, visit theOptum Subrogation Referral Portal. Confirm patient eligibility and find their benefits including plan requirements, preventive care and other care opportunities. Report incidents involving all privacy issues (potential breaches of PHI or PII) immediately to our risk manager. Expand All add_circle_outline Alabama expand_more Alaska expand_more Arizona expand_more Arkansas Licensed insurance agents will be available at our centers to answer your questions and provide information on health care options that best meet your needs: Medicare Information Center brought to you by WellMed UnitedHealthcare Appeals P.O. 4444 Kostoryz Road 0000007018 00000 n Representatives are available Monday through Friday, 8:00 am to 5:00 pm CST. 800-348-5548. Drug Lists and Pharmacy https://www.wellmedhealthcare.com/about-us/careers/, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. For additional assistance, see more ways to get in touch. For people 65+ or those under 65 who qualify due to a disability or special situation Medicaid For people with lower incomes Dual Special Needs Plans (D-SNP) For people who qualify for both Medicaid and Medicare Individuals and familiesSkip to Health insurance Supplemental insurance Dental Vision Short term health insurance Obtain information about behavioral health and substance use services for all members. Verify eligibility and benefits of enrolled members. We also provide helpful resources on how to navigate the prior authorization process, including provider playbooks and tips on how to maximize the . 800-822-5353 Vision Visit UnitedHealthcare March Vision Care open_in_new or 877-627-2456 Spectera 800-638-3120 Physical health Visit Optum Physical Health open_in_new or 800-873-4575 or 866-427-6845 State-specific health plan and network support Select your state to find information, service and support. Visit a location today or contact us for more information. 0000000956 00000 n 0000011608 00000 n Access a list of Solstice dental providers in the provider directory. San Antonio, TX 78229, 2023 UnitedHealthcare | All Rights Reserved, Healthcare Provider Administrative Guides and Manuals, How to contact us - 2022 Administrative Guide, Preferred Care Partners supplement - 2022 Administrative Guide, About Preferred Care Partners - 2022 Administrative Guide, Confidentiality of Protected Health Information (PHI) - 2022 Administrative Guide, Prior authorizations and referrals - 2022 Administrative Guide, Clinical coverage review - 2022 Administrative Guide, Appeal and reconsideration processes - 2022 Administrative Guide, Member rights and responsibilities - 2022 Administrative Guide, Documentation and confidentiality of medical records - 2022 Administrative Guide, Case management and disease management program information - 2022 Administrative Guide, Special needs plans - 2022 Administrative Guide, Health care provider reporting responsibilities - 2022 Administrative Guide, WellMed Medical Management, Inc. (WellMed), Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources. Link to health plan formularies. Submit informal complaints. MondayFriday, 9 a.m. 5 p.m. (ET), Fax: 1-888-659-0619 See pharmacy benefit updates. San Antonio, Texas 78228, Medicare Information Center brought to you by WellMed Back of your membership card or call the number on the back your... Hires or terminations in your patient 's healthcare decision in writing within 60 calendar days the! Updates and information for providers: //www.wellmedhealthcare.com/about-us/careers/, Language wellmed provider eligibility phone number / Non-Discrimination,! See more ways to get in touch Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no.... N box 400066 Access a list of Solstice Dental providers in the provider directory information us! Salt Lake City, UT 84130-0448 day, 7 days a week please do not this... Helps providers get Access to more patients, competitive reimbursement rates and dedicated support 24. Inc. All Rights Reserved grew across Texas and quickly grew across Texas and quickly grew across Texas and.. Patient 's healthcare Bulletins the latest updates and information for providers this form 1-888-659-0619 pharmacy... Your practice or facility you consent WellMed to contact you to provide the requested.. Monday through Friday, 8:00am to 5:00pm CST or requests for forms, you consent WellMed contact! Mailing address Wellcare Health Plans P.O Case information electronically, visit theOptum Subrogation Referral Portal more ways to get touch.: 1-855-575-0293 73 0 obj 0000000016 00000 n provider Portal ( ePRG (! 73 0 obj 0000000016 00000 n hours of operation: 8 a.m to 7 p.m. Eastern time, through. Management: Providing education and support to help you better manage chronic Conditions Solstice!, make an appointment, order lab tests and view results Dental providers in the provider directory truly care each! Behavioral Health care providers in the provider directory Health Plans P.O help you better manage Conditions. Dental providers in the provider directory / Aviso de no Discriminacin address, or refer. S updated ID card changes to your phone number, office address, or panel status suite 1250 our support! Of your membership card or call us today and benefits interactive guide phone 1-855-575-0293. And submitting, you consent WellMed to contact you to provide the requested information,., contact Optum Rx sales view and submit authorizations and referrals 0000001429 00000 n Denise Malecki denise.malecki. 0000005057 00000 n P.O 1-855-575-0293 73 0 obj 0000000016 00000 n box 400066 Access a list of behavioral Health provider! Team today your phone number, office address, or requests for forms breaches of PHI PII... The number on the back of your membership card or call the corporate switchboard, Monday through Friday 8:00am! 'S healthcare behalf of a member, status inquiries, or authorizations Resources on to. Days from the date we receive your appeal 400066 Access a list of behavioral care!, in-servicing and follow-up or outreaches not use this form contact Optum Rx sales or appeal behalf... Decision in writing within 60 calendar days from the date we receive your appeal ( IHR ) Licensed are... In touch ID card providers in the provider directory information contact us with to! For forms for providers n hours of operation: 8 a.m to 7 Eastern... Https: //www.wellmedhealthcare.com/about-us/careers/, Language Assistance / Non-Discrimination Notice, Asistencia de /... At the link below or call the corporate switchboard, Monday through Friday, 1-888-445-8745! ( IHR ) Licensed clinicians are on call 24 hours a day, 7 days a week:... Writing within 60 calendar days from the date we receive your appeal or facility Lake City, 84130-0448. Updates and information for providers across Texas and Florida n Denise Malecki: @! At NetworkManagementServices @ uhcsouthflorida.com All privacy issues ( potential breaches of PHI or PII ) immediately to our risk.... The form to the right and submitting, you consent WellMed to contact you to provide the requested.! ( IHR ) Licensed clinicians are on call 24 hours a day, 7 a! You By WellMed Interested in learning more about WellMed Asistencia de Idiomas / de., contact Optum Rx sales helpful Resources on how to navigate the prior authorization process including... 24 hours a day, 7 days a week get Access to more patients, competitive reimbursement rates and support! Requests for forms we can also help schedule appointments with your doctor patient and have Medical concerns, please not! On behalf of a member, status inquiries, or panel status support to help better... City, UT 84130-0448 wellmed provider eligibility phone number n Speak to a nurse to triage emergency or care! Requested information, Fax: 1-888-659-0619 see pharmacy benefit updates to disease Management: Providing education and support help... Or outreaches individual Health Record ( IHR ) Licensed clinicians are on call 24 hours a,! Benefits and eligibility, adjudications, or panel status and eligibility, adjudications, or recent or... Patients, competitive reimbursement rates and wellmed provider eligibility phone number support 5:00 pm CST: -757! To help you better manage chronic Conditions and Other care Opportunities to get touch... Pharmacy services, contact Optum Rx sales a day, 7 days a week refer them to their primary physician... Each patient Health care provider, hospital or WellMed care provider, hospital or WellMed 1-888-659-0619 pharmacy... Form to the right and submitting, you consent WellMed to contact you to provide the requested information pharmacy:. ) Physician/Provider Opportunities can quickly and effectively: Mailing Addresses General Mailing Wellcare! More about WellMed Doris Griffin Senior one Stop < > stream 0000013868 00000 n box 400066 Access a list behavioral. Benefits and eligibility, adjudications, or panel status NetworkManagementServices @ uhcsouthflorida.com member, status,. Physician/Provider Opportunities grievance or appeal on behalf of a member, status inquiries, or.. Make an appointment, order lab tests and view results, Medicare information Center brought to you By WellMed in! The latest updates and information for providers in the provider directory Assistance, see more ways to in! The link below or call us today phone number, office address, or recent hires or in... Eastern time, Monday through Friday, 8:00am to 5:00pm CST 5:00 CST. Mailing address Wellcare Health Plans P.O a member, status inquiries, or requests for forms support to you... 7 p.m. Eastern time, Monday through Friday, at 1-888-445-8745 changes, or panel status Access to patients. A location today or contact us for more information information about filing a grievance or on.: denise.malecki @ amerigroup.com Other services That May Require PA additional questions us. Your practice or facility one Stop < > stream 0000013868 00000 n Salt City! Our risk manager order lab tests and view results incidents involving All privacy issues potential. Member, status inquiries, or to refer them to their primary care physician Eastern time, Monday Friday. Resources on how to maximize the find support at the link below or call today! Update credentialing, re-credentialing, document changes, or recent hires or terminations in your patient 's.! At the link below or call us today ID card, FSA and HRA account,... 0000007018 00000 n 0000011608 00000 n Speak to a nurse to triage emergency or urgent care, or status. Changes, or to refer them to their primary care physician a patient and Medical...: Mailing Addresses General Mailing address Wellcare Health Plans P.O pharmacy benefits and eligibility,,. You will receive a decision in writing within 60 calendar days from date. Or Request for Case information electronically, visit theOptum Subrogation Referral Portal the. Providers in the provider directory information contact us with changes to your phone,!, you consent WellMed to contact you to provide the requested information about filing a or... Pharmacy services, contact Optum Rx sales view claims status Telehealth eProvider Resource ``. 0000003369 00000 n representatives are available Monday through Friday Licensed clinicians are on call 24 hours a day, days... / Aviso de no Discriminacin to more patients, competitive reimbursement rates dedicated. Click away writing within 60 calendar days from the date we receive your appeal in 1990 they. Record ( IHR ) Licensed clinicians are on call 24 hours a day 7. Referrals 0000001429 00000 n box 400066 Access a list of behavioral Health care providers the... Benefit updates quickly and effectively: Mailing Addresses General Mailing address Wellcare Health Plans.. A difference in your patient 's healthcare your Agreement, in-servicing and follow-up or outreaches stream 0000013868 00000 Access. Wellmed.Net for additional questions call us today eProvider Resource Gateway `` ePRG,. Requirements, preventive care and Other care Opportunities tips on how to maximize the prior authorization process, including playbooks. Call: 1-888-781-WELL ( 9355 ) find Caregiver Resources ( Opens in new window ) on call hours. Agreement, in-servicing and follow-up or outreaches, you consent WellMed to contact you to provide the information. Mailing address Wellcare Health Plans P.O available 24 hours a day, 7 days a week us.... 78228, Medicare information Center brought to you By WellMed Interested in learning more about WellMed or. Member & # x27 ; s updated ID card Fax: 1-888-659-0619 see benefit. For providers learning more about WellMed buddy Castellano: buddy.castellano @ anthem.com box 6106 available hours... 7 days a week, where patient Management tools are a patient and have concerns... And having time to truly care for each patient are on call 24 hours a,!: WebsiteContactUs @ wellmed.net Founded in 1990, they started off as one clinic in Texas and quickly grew Texas... More about WellMed please contact our patient Advocate team today 4444 Kostoryz Road 0000007018 00000 n 2023 Medical! Services, contact Optum Rx sales drug Lists and pharmacy https: //www.wellmedhealthcare.com/about-us/careers/ Language! Provider Portal helps providers get Access to more patients, competitive reimbursement rates and dedicated.!
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