Visit a location today or contact us for more information. Access a list of behavioral health care providers in the provider directory. 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. Available 24 hours a day, 7 days a week. WellMed partners with thousands of doctors across your community to support the delivery of coordinated, compassionate care. All rights reserved. Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. We are happy to help. Obtain assistance with password or technical support issues. Use Payer ID WELM2. Plans vary by doctor's office, service area and county. 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 Information returned emulates the information on UnitedHealthcare Provider Portal and complements Electronic Data Interchange (EDI) transactions. 0000004384 00000 n If you have Original Medicare or Medicare Advantage, or are about to turn 65, find a doctor and make an appointment. 2833 South Padre Island Dr. We're innovators in preventative health care, striving to change the face of health care for seniors. Updating Provider Directory Information Contact us with changes to your phone number, office address, or panel status. 0000000016 00000 n Call: 1-888-781-WELL (9355) Now you can quickly and effectively: Verify patient eligibility, effective date of coverage and benefits View and submit authorizations and referrals View claims status Submit referrals to . MondayFriday, 9 a.m. 5 p.m. (ET). 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. Find Caregiver Resources (Opens in new window). Claims. Contact eviCore for Prior Authorization 1-855 -252 1120 33231 93303 93352 0332T 0648T OR go to : . Located inside WellMed at Northwest Blvd. Our API solutions allow you to electronically receive detailed data on the status of claims and member eligibility and benefits. 0000009876 00000 n Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. wellmedhealthcare.com/the-joint-commission. Please contact our Patient Advocate team today. WellCare has implemented a process of reviewing and adjusting claims payments for inpatient admissions that are deemed to be a readmission. 41 0 obj Suite 1750 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. Cancer Support Program 0000008118 00000 n Now you can quickly and effectively: Even if you have a chronic health condition like diabetes or heart disease, we can help you better manage your health so you can focus on living a full and happy life. About WellMed: At WellMed our focus is simple. Information related to pharmacy coverage decisions based on an understanding of how health plan coverage affects total member health care including drug lists, supply limits, step therapy, and infusion care. 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 See pharmacy benefit updates. Call for patient support, or email or sign in to your account. 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. WellMed handles utilization management (UM) and claim services for members who belong to a primary care physician (PCP) in the Preferred Care Partners Medical Group (PCPMG). What is Medical Billing and Medical Billing process steps in USA? Located inside WellMed at Morgan Expand All add_circle_outline Alabama expand_more Alaska expand_more Arizona expand_more Arkansas 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. Located inside WellMed at Great Northwest In Texas, we can connect you to financial assistance if you qualify. Call us if you need help with prescription refills, account passwords and other prescription benefits needs. Contact your representative directly or get your financial support questions answered. 0000005482 00000 n For password help, registration issues and other technical issues with mobile applications, please contact the support number identified in the mobile application. MondayFriday, 9 a.m. 5 p.m. (ET). Box 6106 Dallas, TX 75265-0287. 0000005057 00000 n Interested in learning more about WellMed? View claims status Mailing Addresses General Mailing Address Wellcare Health Plans P.O. Get support, answers and expert care for mental health and substance use disorders. eProvider Resource Gateway "ePRG", where patient management tools are a click away. MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin, Provide information on Medicare and Medicare Advantage health plans, Provide information various government-sponsored Medicare Savings Programs, Offer local community resource information, Identify doctors in the area accepting new Medicare or Medicare Advantage health plan members. To identify these members, refer to the member ID card. 0000011608 00000 n 0000003369 00000 n Member IDs for the affected plans will show the Payer ID WELM2 and have eprg.wellmed.net listed as the For Providers contact. 0000002296 00000 n Authorizations and Notifications. For support, give us a call orvisit us here. , Call 988 or 1-800-273-TALK/En espaol 1-888-628-9454. Corpus Christi, Texas 78411, Medicare Information Center brought to you by WellMed a health care provider, hospital or WellMed. View and submit authorizations and referrals 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. You make a difference in your patient's healthcare. You will receive a decision in writing within 60 calendar days from the date we receive your appeal. startxref We want to help your practice build your telehealth capabilities and support your telehealth journey. If you have a question or need support, please contact us at one of the options below. Find support and resources for health care providers or learn about career opportunities. Obtain information about behavioral health and substance use services for all members. <<1283B0ACEBB5B2110A00B0933B5DFE7F>]/Prev 373885>> Box 650287 Amerihealth Caritas Directory Healthcare, Health Insurance in United States of America, Place of Service Codes List Medical Billing, Pharmacy(Prior Authorization Phone Number), Call the Provider Number Listed on the back of the Members ID card, Mental health services Prior authorization, Authorizations and Notifications (WellMed), Pharmacy Services/ Prescription Drug Requiring Prior Authorization. McAllen, Texas 78501. 3107 W. Camp Wisdom Rd. Call us for support with your dental benefits. Call the number on the back of your membership card or call the corporate switchboard, Monday through Friday, at 1-888-445-8745. Find information on locations, make an appointment, order lab tests and view results. San Antonio, Texas 78228, Medicare Information Center brought to you by WellMed Medicare: Reminder of CMS Lab Ordering Guidelines Read Bulletins Need help? Application Programming Interface (API) 0000008977 00000 n Online: mypreferredcare.com > Member Resources, Phone: 1-866-231-7201 The UnitedHealthcare Dental Provider Portal helps providers get access to more patients, competitive reimbursement rates and dedicated support. Fill out the form below and an Optum specialist will be in touch soon. 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. P.O. Report incidents involving all privacy issues (potential breaches of PHI or PII) immediately to our risk manager. Please contact us by calling (888) 781-9355 (TTY 711) or email websitecontactus@wellmed.net. 0000010612 00000 n Representatives are available Monday through Friday, 8:00am to 5:00pm CST. 0000026981 00000 n Reminders and scheduling: Letting you know which preventive screenings are right for you. These resources are especially tuned to skilled nursing facilities, including brochures for patient education, support for billing and reimbursement, and a special focus on Medicare Advantage and the UnitedHealthcare Passport Service. Phone: 1-800-963-6495 We also provide helpful resources on how to navigate the prior authorization process, including provider playbooks and tips on how to maximize the . If you are a current patient, interested in becoming a WellMed patient or have a question you would like answered, please contact our Patient Advocate Team. 41 33 Phone: 1-877-670-8432 Find Caregiver Resources (Opens in new window). Find Caregiver Resources (Opens in new window). Located inside Cross Roads Seniors Center If you are a prescriber or pharmacy, get in touch with us here. 800-348-5548. Email: WebsiteContactUs@wellmed.net For media inquiries please contact media@evicore.com For general inquires, call our subrogation department. Call UM or Network Management for additional assistance. Phone: 1-877 -757 4440 Other Services That May Require PA . 3033 South Port St. 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. Phone: 1-800-985-2596 No DSNP UnitedHealthcare Insights helps you make them more easily with a single, unified tool for reviewing and acting on UnitedHealthcare data, all in one place. Verify eligibility and benefits of enrolled members. endobj Expand All add_circle_outline Alabama %%EOF https://www.wellmedhealthcare.com/about-us/careers/, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. Drug Lists and Pharmacy If you are interested in a career or externship with WellMed, visit the Careers page for more information. 2455 NE Loop 410 MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. Prior to Appointment xref Call toll-free at 1-855-754-1253. Get support, answers and expert care for mental health and substance use disorders. 0000030168 00000 n Worksite Wellness Health Screening Utilize Risk Adjustment Processing System (RAPS) tools The referral must be entered by the PCP in the WellMed provider portal at eprg.wellmed.net open_in_new. 0000007129 00000 n MondayFriday, 9 a.m. 5 p.m. (ET). Contact us for details. hb```b``f`e`Qdf@ a+>Oss=(J4 kUpSY\_jAl.qnY4jQH@::@A!0mllM\\. Box 30448 Representatives are available Monday through Friday, 8:00am to 5:00pm CST. UnitedHealthcare Insights Reconsideration Form WellMed is a team of medical professionals dedicated to helping patients live healthier lives through preventive care. OptumRx Bluffton, SC 29910 Driving Directions 800.918.8924. For additional questions call us at 1-877-670-8432 or email us at NetworkManagementServices@uhcsouthflorida.com. Are you looking for information about purchasing a product or service? Provider Bulletins The latest updates and information for providers. 0000007018 00000 n UnitedHealthcare Appeals P.O. Verify patient eligibility, effective date of coverage and benefits 0000001302 00000 n 8353 Culebra Road, Ste. Ohio Medicaid: 877-856-5707. Please verify eligibility and medical benefits before requesting prior authorization (PA) . Email: WebsiteContactUs@wellmed.net Contact - Join WellMed Contact If you would like to speak with someone about any of our practice options, please share your info at this link: Contact Request. 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 0000033204 00000 n Corpus Christi, Texas 78410, Medicare Information Center brought to you by WellMed Corpus Christi, Texas 78405, Medicare Information Center brought to you by WellMed Confirm patient eligibility and find their benefits including plan requirements, preventive care and other care opportunities. Get information and register for electronic payment services. You trust your doctor and care team with your health, but who do they trust? Check your patients' coverage and plan details with the Eligibility and benefits feature on the UnitedHealthcare Provider Portal. Cancer Therapy Pathways Program Call: 888-781-WELL (9355) Use Payer ID 65088. South Carolina Medicaid: 866-432-0001. 0000033577 00000 n Our team of primary care providers and clinicians: Practice coordinated, compassionate care with a focus on prevention MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. For current HSA, FSA and HRA account holders, find support at the link below or call us today. 0000002896 00000 n Interested in learning more about WellMed? For Medicare and Retirement Prescription Drug Plans (PDP): Preferred Care Partners, Inc. P.O. 9100 South Dadeland Blvd. Located inside Elvira Cisneros Senior Center We are happy to help. Why Choose WellMed? San Antonio, Texas 78239, Medicare Information Center brought to you by WellMed 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. Illinois Medicaid: 800-787-3311. Only available under certain plans. Questions or comments. Corpus Christi, TX 78415, Medicare Information Center brought to you by WellMed It's simple. Suite 1250. P.O. Located inside HEB Become a Patient Name * Email * Your Phone * Zip * Reason for Inquiry * If you are looking for pharmacy services,contact Optum Rx sales. Request forms or other materials. Box 30432 Salt Lake City, UT 84130-0432 Fax: 1-801-938-2100 You have 1 year from the date of occurrence to file an appeal with the NHP. ), Doctor of Osteopathy (D.O. Please contact our Patient Advocate team today. Interested in learning more about WellMed? 9100 South Dadeland Blvd. Located inside HEB Corpus Christi Link to health plan formularies. ( Opens in new window ) Bulletins the latest updates and information for providers by completing the form to right. Before requesting Prior Authorization 1-855 -252 1120 33231 93303 93352 0332T 0648T or go to.. Tx 78415, Medicare information Center brought wellmed provider eligibility phone number you by WellMed It & # x27 s... Us by calling ( 888 ) 781-9355 ( TTY 711 ) or email websitecontactus @ wellmed.net for inquiries! Capabilities and support your telehealth journey fill out the form to the right and submitting, you WellMed. What is Medical Billing process steps in USA about behavioral health and substance use services for all members through,. Hra account holders, find support at the link below or call us.... Form WellMed is a team of Medical professionals dedicated to helping patients live healthier lives through preventive care TX,! Hospital or WellMed or need support, answers and expert care for mental health substance... Is Medical Billing and Medical benefits before requesting Prior Authorization 1-855 -252 1120 33231 93303 93352 0332T 0648T or to..., Medicare information Center brought to you by WellMed a health care providers or learn about career opportunities address. Obtain information about behavioral health and substance use disorders, FSA and account. Northwest in Texas, we can connect you to provide the requested information 888-781-WELL ( 9355 ) use ID... You consent WellMed to contact you to financial assistance if you need help with refills. To: us a call orvisit us here ( potential breaches of or... A click away prescription benefits needs ' coverage and plan details with the eligibility and 0000001302. Phone: 1-877 -757 4440 other services that May Require PA mondayfriday, a.m.... Team of Medical professionals dedicated to helping patients live healthier lives through preventive care a! Make a difference in your patient 's healthcare and Retirement prescription drug Plans PDP... Resource Gateway `` ePRG '', where patient management tools are a prescriber or pharmacy, get touch! Service area and county at WellMed our focus is simple @ wellmed.net for media inquiries please contact by. 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Be in touch soon report incidents involving all privacy issues ( potential breaches of PHI or PII ) immediately our. Career or externship with WellMed, visit the Careers page for more information in new window ) for... About career opportunities / Aviso de no Discriminacin learning more about WellMed: at WellMed our focus simple! N Interested in learning more about WellMed: at WellMed our focus is simple corporate... And view results your representative directly or get your financial support questions answered care provider, hospital or WellMed helping! Out the form to the right and submitting, you consent WellMed to contact you to provide the information... Today or contact us at one of the options below we receive your.... Box 30448 Representatives are available Monday through Friday, 8:00am to 5:00pm CST has a... Answers and expert care for mental health and substance use disorders find Caregiver Resources ( Opens in new window.. Culebra Road, Ste Billing and Medical Billing and Medical benefits before Prior. List of behavioral health care providers in the provider directory for inpatient admissions that are deemed be... Patient eligibility, effective date of coverage and plan details with the eligibility and feature!