The provider training materials supply our providers with educational resources regarding initiatives that require specific actions by providers.

CareCoreNational Radiology Program

WellCare has partnered with CareCore National in a few states to provide quality support in managing prior authorization for certain outpatient radiology services at participating WellCare sites. The resources below may help you understand the prior authorization process for radiologic services. 

Be sure to click on the appropriate state resources for the most accurate information. If your state is not listed, you should continue to submit all prior authorization requests to WellCare.

Georgia (effective 5/3/10)

Provider Notice (Medicare)
Provider Notice (Medicaid)
Provider Training - Overview of Radiology Program
Radiology Program Job Aid
CareCore National Frequently Asked Questions

Florida (effective 6/1/10)

Provider Notice 
Provider Training - Overview of Radiology Program
Radiology Program Job Aid 
CareCore National Frequently Asked Questions 

CMS-Mandated Fraud, Waste and Abuse Training

The Centers for Medicare & Medicaid Services (CMS) has mandated that all delegated and contracted providers who render benefits or services for Medicare Part C and Part D programs must meet fraud, waste and abuse (FWA) training requirements by December 31, 2009. Click here for more information on how to fulfill this requirement.

Medicare Model of Care

Pursuant to MIPPA legislation, WellCare has enhanced our Model of Care program for all WellCare Dual Special Needs Plans (D-SNPs) members. The Model of Care is designed to improve members’ access to medical, social and mental health services while improving transitions of care across health care settings and Providers. The resources below may be used to prepare providers on the implementation of the requirements of the Model of Care program.

• Provider Training
• Frequently Asked Questions
• Job Aid
• Sample Care Plan