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Wellcare

Medicare providers serving Wellcare By Allwell and Wellcare By Superior HealthPlan members can find the information and resources they need on our website. Below are sections to review and reference as you work with Medicare patients.

Wellcare Superior HealthPlan Dual Align (HMO D-SNP) providers delivering Medicare covered services must be enrolled as a Medicare provider through CMS and also enrolled as a Medicaid provider through the Texas Health and Human Services Commission. If you have any questions or need additional information or assistance, please reach out to your local Provider Representative or contact Provider Services.

Please note: If you’re a provider serving Wellcare members, provider information and resources can be found on the Wellcare website.

Wellcare Superior HealthPlan Dual Align (HMO D-SNP) providers delivering Medicare covered services must be enrolled as a Medicare provider through CMS and also enrolled as a Medicaid provider through the Texas Health and Human Services Commission. Providers can visit the Texas Medicaid & Health Partnership website for additional information and resources for Texas Medicaid provider enrollment.

If you’re interested in joining the Wellcare or Medicaid network as a participating provider, or need to add a product to your existing contract, you can visit our Network Request or Update webpage.

Please note: Providers who contract with Wellcare By Superior HealthPlan (to be part of the Duals network) will only display in the integrated Provider Directory, not in the Medicaid directory.

Credentialing forms can be found on Superior's Provider Forms webpage, under the Credentialing section. 

Providers can login to Availity Essentials to manage claims and other tasks quickly and easily, including:

  • Submitting claims
  • Checking claims status
  • Submitting authorizations
  • Checking eligibility and benefits

If your organization is new to Availity, start by registering with Availity today through the Availity Multi-Payer Portal Registration webpage.

Additional options and information on claims processes and procedures are outlined in your Provider Manual.

Providers can register for the provider portal by visiting our Secure Provider Portal.

Wellcare By Allwell (HMO and HMO SNP)

To check if a service requires prior authorization, reference the online Medicare Prior Authorization tool.

Wellcare By Superior HealthPlan (D-SNP)

To check if a service requires prior authorization, reference the online D-SNP Prior Authorization tool – coming soon.

  • Inpatient D-SNP Authorization Form (PDF) – coming soon
  • Outpatient D-SNP Authorization Form (PDF) – coming soon

Additional forms can be found on Superior's Provider Forms webpage, under the Wellcare By Allwell (HMO and HMO SNP) and Wellcare By Superior HealthPlan (D-SNP) sections. 

Wellcare By Allwell (HMO and HMO SNP)

Wellcare By Superior HealthPlan (D-SNP)

Wellcare By Allwell (HMO and HMO SNP)

Wellcare By Superior HealthPlan (D-SNP)

  • Wellcare By Superior HealthPlan Provider Training (PDF) – coming soon

To view upcoming live webinar trainings and RSVP, please visit our Provider Training Calendar.

Wellcare By Allwell (HMO and HMO SNP)

Wellcare By Superior HealthPlan (D-SNP)

  • Wellcare By Superior HealthPlan Provider Manual (PDF) – coming soon
  • Wellcare By Superior HealthPlan Appeals and Grievances QRG (PDF) – coming soon
  • Wellcare By Superior HealthPlan Claims, Disputes & Recovery QRG (PDF) – coming soon
  • Wellcare By Superior HealthPlan QRG (PDF) – coming soon
  • Wellcare By Superior HealthPlan Pharmacy QRG (PDF) – coming soon
  • Wellcare By Superior HealthPlan Prior Authorization QRG (PDF) – coming soon

Stay updated on all Wellcare news and information by signing up for our Provider Newsflash (e-newsletter) and review all provider notices through our Provider News & Information webpage.