Provider : Resources

WellCare of Kentucky 

The resources on this page will assist you in working with WellCare of Kentucky.  Click on the names of the materials listed to access more information. These materials may change over time so please check back to make sure you have the most up-to-date version. If you have questions, please call Customer Service at 1-877-389-9457 (TTY/TDD 1-877-247-6272).

Provider Manual 
An extension of the Participation Agreement and a resource that provides guidelines on health plan coverage procedures, policies and other information related to the provision of health care services to our members. This document should be used simultaneously with the Provider Quick Reference Guide and other reference resources.
 

Quick Reference Guide (QRG)
Provides important contact information and authorization guidelines.

Forms and Documents
Template forms and documents for appeals, authorizations, claims, pharmacy services and more.

Clinical Coverage Guidelines
Evidence-based guidelines detailing the medical necessity of, and sets consistent criteria for coverage of, given procedures or technologies to ensure greater consistency and efficiency in clinical decision making.

Clinical Practice Guidelines
Best-practice guidelines used to guide efforts in improving the quality of care in our membership.  CPGs are based on available clinical outcome and scientific evidence-based content developed by expert professional and clinical society recommendations.

Provider Training and Education
Educational resources regarding initiatives that require specific actions by providers. You must log in to complete required Provider training. 
 

Provider Job Aids and Resource Guides
Resource documents and instructions on how to perform daily tasks with WellCare of Kentucky.  

Claims Updates
Provides updates on WellCare’s claims processes, ensuring that provider claims are handled efficiently.

Provider Newsletters
WellCare produces newsletters to update providers on information related to pharmaceuticals, cost and quality of care or to share tips on how to perform business more efficiently with the Plan. The newsletters are also used to highlight recent successes, such as accreditations and quality scores.