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S rendered on members enrolled in a health plan where claims payment is administered by WellMed Medical Management. NOTE: Please submit a separate claim reconsideration request form for each reconsideration request No new claims should be submitted with this form. Do not use this form for formal appeals or disputes. Continue to use your standard appeals process for formal appeals or disputes. Please refer to your provider manual for additional details including where to send Claim Reconsideratio.
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Wellmed provider appeals FAQ
WellMed is a health care company and affiliate of UnitedHealthcare that manages care authorizations, referrals and claims for UnitedHealthcare Medicare Advantage members assigned to WellMed PCPs. Do members with a WellMed PCP need to be referred to certain specialists and hospitals?
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WellMed is a health care company and affiliate of UnitedHealthcare that manages care authorizations, referrals and claims for UnitedHealthcare Medicare Advantage members assigned to WellMed PCPs. Do members with a WellMed PCP need to be referred to certain specialists and hospitals?
WellMed is now part of OptumCare™ as they work hard to provide specialized care to keep patients empowered and engaged in their own health. We accept traditional Medicare and a number of Medicare Advantage health insurance plans to help provide affordable health care options.
WellMed accepts Original Medicare and certain Medicare Advantage health plans. If you have Original Medicare or Medicare Advantage, or are about to turn 65, find a doctor and make an appointment. Plans vary by doctor's office, service area and county. Some doctors' offices may accept other health insurance plans.
WellMed Medical Group is a physician-led, physician-driven company specializing in the complete health care coordination for patients in Texas.
WellMed requires a referral from the assigned PCP before rendering services for selected specialty care providers. The referral must be entered by the PCP in the WellMed provider portal at eprg.wellmed.netopen_in_new.
Payer NamePayer IDERAsWELLCARE BY TRILLIUM ADVANTAGE68069YesWELLCARE HEALTHPLAN - ENCOUNTERS59354YesWELLMARK ADVANTAGE HEALTH PLAN88848YesWELLMED CLAIMSWELM2Yes26 more rows
Wellmed provider appeals address Related content
Texas Standard Prior Authorization Request Form...
Do not use this form to: 1) request an appeal; 2) confirm eligibility; 3) verify coverage;...
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