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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).
Authorization Lookup Tool
Search quickly and easily by CPT code.
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
Provides important contact information and authorization guidelines.
Forms and Documents
Template forms and documents for appeals, authorizations, claims, pharmacy services and more.
Information about advance directives and living wills should be available in provider offices and discussed with members. Members have the right to control decisions related to their medical care, including the decision to withhold or remove any medical or surgical means or procedures to prolong their lives.
Please see the Provider Manual and Advance Directives for Mental Health Treatment for more information.
Provides updates on WellCare’s claims processes, ensuring that provider claims are handled efficiently.
Clinical Coverage Guidelines
Evidence-based guidelines detailing the medical necessity of procedures or technologies. Note: Please check the Position Statement in each CCG to determine coverage determination for your state/market.
Clinical Practice Guidelines
Best-practice recommendations based on available clinical outcome and scientific evidence.
WellCare will be compliant with the Centers for Medicare & Medicaid Services (CMS) rule for ICD-10 readiness beginning Oct. 1, 2015. We have compiled important information and Frequently Asked Questions for providers.
Job Aids and Resource Guides
Resource documents and instructions on how to perform daily tasks with WellCare of Kentucky.
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.
Training and Education
Educational resources regarding initiatives that require specific actions by providers. You must log in to complete required Provider training.