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Welcome to WellCare's Producer Resource Center!

Our Resource Center houses news, information and valuable sales tools that can help producers both attract and retain members. WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare.

Why Sell for WellCare?

WellCare welcomes producers who share our commitment to compliance and member satisfaction. As a Fortune 500 company headquartered in Tampa, Florida, WellCare can offer producers our experience and our exclusive commitment to government-sponsored health care programs.

Commitment to Compliance

Compliance is imperative for all of us, and we must make sure that we remain steadfast in our efforts to make compliance a part of everything we do. WellCare is committed to making our producers the most informed and compliant in the industry by providing the tools and resources necessary to meet this objective.

Dedicated Support

You now have local assistance to help with all of your WellCare needs.  We ask that you contact your local District Sales Manager as your direct line of support.  These managers are familiar with your particular area and will best be able to support you on a local level with anything from supplies and training questions to enrollment and commission issues.  If you have any questions or need assistance, please contact your local District Sales ManagerThis PDF document will open in a new window.. For further support, please visit WellCare's Secured Producer Portal for access to annual training information, applications and enrollments status, commission tracking, sales and marketing tools/materials, event management materials, and more! Please reference the Using the Secured Producer Portal GuideThis PDF document will open in a new window..

 

Important Information

Appointment Verification Line (AVL)

Scope of Appointment (SOA) Process In order to ensure the Scope of Appointment (SOA) is documented, WellCare requires all SOAs to be telephoned and logged by our Appointment Verification Line. This record is electronically maintained for 10 years and can be easily accessed via request. Producers still need to maintain their own records for Consent to Contact, but WellCare accepts the responsibility of maintaining the SOA.

PDP Appointment Verification Line: 877-297-3625

Only use this line if you are NOT in the following states:

CT, FL, GA, HI , IL, LA, MO, NJ, NY, OH, TX

Please use the appropriate number for your respective market:

contac-us

Monday - Sunday: 8 a.m. - 8 p.m., Eastern.

Arizona: 877-879-8955
Arkansas: 866-563-5134
Connecticut: 877-819-1157
Florida (East): 877-819-2980
Florida (South): 877-820-4938
Florida (West): 877-829-6303
Georgia (Central-SW): 877-819-1156
Georgia (North): 877-819-1155
Georgia (Southeast): 877-821-1519
Hawai'i: 877-248-7509
Illinois: 877-819-2984
Kentucky: 877-780-3896
Louisiana: 877-819-3239


Mississippi: 866-549-9476
Missouri: 877-819-3241
New Jersey: 877-819-3247
New York (Downstate): 877-819-1160
New York (Upstate): 877-821-1528
Ohio: 877-819-5829
South Carolina: 866-561-9818
Tennessee: 866-563-2756
Texas (Dallas): 877-819-1159
Texas (Houston): 877-819-2982
Texas (San Antonio): 877-819-5830

Electronic Enrollment Verification Line - ePAV: 866-915-7670 (QA Test)

Monday – Sunday: 8 a.m. - 2 a.m., Eastern.

Paper Application Fax: 866-473-9124

Paper applications received by a sales agent must be faxed to WellCare within 48 hours of receipt.

Paper Scope Exception Fax: 866-354-8713


Medicaid Verification Line: 866-211-0544

Monday – Friday: 8 a.m. - 10 p.m., Eastern
Saturday: 8 a.m. - 3 p.m., Eastern

Appointment Verification Line (AVL)_Updated EnrollmentLine

Scope of Appointment (SOA) Process In order to ensure the Scope of Appointment (SOA) is documented, WellCare requires all SOAs to be telephoned and logged by our Appointment Verification Line. This record is electronically maintained for 10 years and can be easily accessed via request. Producers still need to maintain their own records for Consent to Contact, but WellCare accepts the responsibility of maintaining the SOA.

Member Services

Member Services

If you have a question about specific prospect or member, please reach out to our Member Services team.     

Monday – Sunday: 8 a.m. - 8 p.m., Eastern.

 

PDP: 888-550-5252
Arizona:  877-560-3213
Connecticut:  866-579-8006
Florida:  888-888-9355
Georgia:  866-334-7730
Hawaii: 888-505-1201
Illinois:  866-334-6876
Kentucky:  877-560-2766
Louisiana:  866-804-5926
Missouri:  866-687-8994
New Jersey:  866-687-8570
New York: 800-278-5155
Ohio:  866-687-8815
Texas:  866-687-8878

RFI Remediation Line: 877-677-5609

Producers can now resolve Enrollment Requests for Information (RFI) by calling a centralized line and providing the necessary information to the representative for immediate correction and submission.

The benefits of this line are:

  • Centralized intake for RFI remediation.
  • Reduction in duplicate enrollment submissions.
  • Reduction in RFI remediation timeline.
  • Reduced administration to resolve RFI, i.e. duplication of efforts.

This process may require the producer to reach out to the beneficiary to obtain updated information prior to calling the RFI line. Below are the codes and a short description of the information needed to resolve an issue:

RFI Code

This process may require the producer to reach out to the beneficiary to obtain updated information prior to calling the RFI line. Following are the codes and a short description of the information needed to resolve an issue:

 

RFI Code Descriptions
HICN Not Found Transposed, Missing HICN
Demographic Correction Name, DOB, Gender, etc.
Plan Code Correction Incorrect Plan Selected for Eligibility
Perm Address Address Corrections
ESRD Information Missing answer to the ESRD Question
Part A and Part B Missing Missing Effective Dates
Updated or Add SNP Verification # Caid Validation Number not noted
  • Appointment Numbers

    Appointment Verification Line (AVL)

    Scope of Appointment (SOA) Process In order to ensure the Scope of Appointment (SOA) is documented, WellCare requires all SOAs to be telephoned and logged by our Appointment Verification Line. This record is electronically maintained for 10 years and can be easily accessed via request. Producers still need to maintain their own records for Consent to Contact, but WellCare accepts the responsibility of maintaining the SOA.

    PDP Appointment Verification Line: 877-297-3625

    Only use this line if you are NOT in the following states:

    CT, FL, GA, HI , IL, LA, MO, NJ, NY, OH, TX

    Please use the appropriate number for your respective market:

    contac-us

    Monday - Sunday: 8 a.m. - 8 p.m., Eastern.

    Arizona: 877-879-8955
    Arkansas: 866-563-5134
    Connecticut: 877-819-1157
    Florida (East): 877-819-2980
    Florida (South): 877-820-4938
    Florida (West): 877-829-6303
    Georgia (Central-SW): 877-819-1156
    Georgia (North): 877-819-1155
    Georgia (Southeast): 877-821-1519
    Hawai'i: 877-248-7509
    Illinois: 877-819-2984
    Kentucky: 877-780-3896
    Louisiana: 877-819-3239


    Mississippi: 866-549-9476
    Missouri: 877-819-3241
    New Jersey: 877-819-3247
    New York (Downstate): 877-819-1160
    New York (Upstate): 877-821-1528
    Ohio: 877-819-5829
    South Carolina: 866-561-9818
    Tennessee: 866-563-2756
    Texas (Dallas): 877-819-1159
    Texas (Houston): 877-819-2982
    Texas (San Antonio): 877-819-5830

  • Enrollment Lines

    Electronic Enrollment Verification Line - ePAV: 866-915-7670 (QA Test)

    Monday – Sunday: 8 a.m. - 2 a.m., Eastern.

    Paper Application Fax: 866-473-9124

    Paper applications received by a sales agent must be faxed to WellCare within 48 hours of receipt.

    Paper Scope Exception Fax: 866-354-8713


    Medicaid Verification Line: 866-211-0544

    Monday – Friday: 8 a.m. - 10 p.m., Eastern
    Saturday: 8 a.m. - 3 p.m., Eastern

    Appointment Verification Line (AVL)_Updated EnrollmentLine

    Scope of Appointment (SOA) Process In order to ensure the Scope of Appointment (SOA) is documented, WellCare requires all SOAs to be telephoned and logged by our Appointment Verification Line. This record is electronically maintained for 10 years and can be easily accessed via request. Producers still need to maintain their own records for Consent to Contact, but WellCare accepts the responsibility of maintaining the SOA.

  • Member Services

    Member Services

    Member Services

    If you have a question about specific prospect or member, please reach out to our Member Services team.     

    Monday – Sunday: 8 a.m. - 8 p.m., Eastern.

     

    PDP: 888-550-5252
    Arizona:  877-560-3213
    Connecticut:  866-579-8006
    Florida:  888-888-9355
    Georgia:  866-334-7730
    Hawaii: 888-505-1201
    Illinois:  866-334-6876
    Kentucky:  877-560-2766
    Louisiana:  866-804-5926
    Missouri:  866-687-8994
    New Jersey:  866-687-8570
    New York: 800-278-5155
    Ohio:  866-687-8815
    Texas:  866-687-8878
  • RFI

    RFI Remediation Line: 877-677-5609

    Producers can now resolve Enrollment Requests for Information (RFI) by calling a centralized line and providing the necessary information to the representative for immediate correction and submission.

    The benefits of this line are:

    • Centralized intake for RFI remediation.
    • Reduction in duplicate enrollment submissions.
    • Reduction in RFI remediation timeline.
    • Reduced administration to resolve RFI, i.e. duplication of efforts.

    This process may require the producer to reach out to the beneficiary to obtain updated information prior to calling the RFI line. Below are the codes and a short description of the information needed to resolve an issue:

    RFI Code

    This process may require the producer to reach out to the beneficiary to obtain updated information prior to calling the RFI line. Following are the codes and a short description of the information needed to resolve an issue:

     

    RFI Code Descriptions
    HICN Not Found Transposed, Missing HICN
    Demographic Correction Name, DOB, Gender, etc.
    Plan Code Correction Incorrect Plan Selected for Eligibility
    Perm Address Address Corrections
    ESRD Information Missing answer to the ESRD Question
    Part A and Part B Missing Missing Effective Dates
    Updated or Add SNP Verification # Caid Validation Number not noted
  • Important Links
contac-us

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Update on Heritage Health Member ID Cards WellCare has sent ID cards to members in the Heritage Health Nebraska plan. These ID cards should arrive soon, but if you have not received your ID card and need immediate care, please contact customer service at 1-855-599-3811 for assistance. ×