Company Information

OEP SPOP HOURS
Monday through Friday 8 a.m. to 10 p.m. EST
Saturday 8 a.m. to 4 p.m. EST
Sunday 1 p.m. to 4 p.m. EST

Producer Services:

• Phone number: 866-822-1339

• Email: producerservices@wellcare.com

Contact Information for Local District Sales Managers:
To view a full list of WellCare’s local district sales managers, please click here.

Contact for Plan Changes:
For plan changes, please call WellCare’s Call Center at 877-386-4048.

Link to New Formulary Page on WellCare’s Site:
https://www.wellcare.com/en/Producers/2016-Formularies

Appointment Verification Lines (AVL):

Market Toll-Free Numbers:

• Missouri: 877-819-3241

• Connecticut: 877-819-1157

• Upstate New York: 877-821-1528

• Texas – Houston: 877-819-2982

• Texas – San Antonio: 877-819-5830

• New Jersey: 877-819-3247

• Illinois: 877-819-2984

• Ohio: 877-819-5829

• Georgia – Atlanta: 877-819-1155

• Georgia – Columbus: 877-819-1156

• Georgia – Savannah: 877-821-1519

• Florida – Orlando/Jacksonville: 877-819-2980

• Florida – Miami/Dade/Broward: 877-820-4938

• Florida – Tampa/Lakeland: 877-819-3239

• Hawaii: 877-248-7509

• Louisiana: 877-829-6303

• Nebraska: 877-297-3625

WellCare Enrollment Verification Line:

• 866-915-7670

CCP Enrollment Fax:

• 866-473-9124

PDP Enrollment Fax:

• 866-388-1521

If the member is hard of hearing or their language spoken is not supported, please call the AVL line and ask for a paper exception. You will then need to fax the paper Scope of Appointment Form to 1-866-354-8713.

Producers can now resolve Enrollment Requests for Information (RFI) by calling a centralized line and providing the necessary information to the representative for immediate correction and submission.

RFI Remediation Line: 877-677-5609

The benefits of this line are as follows:

• Centralized Intake for RFI remediation

• Reduction in duplicate enrollment submissions

• Reduction in the RFI remediation timeline

• Reduced administration to resolve RFI, i.e. duplication of efforts

This process may require the Producer to reach out to the Beneficiary and obtain the updated information and call the RFI line secondarily. Below are the codes and a short description of the information needed to resolve:

RFI Code: HICN Not Found Description: Transposed, Missing HICN

RFI Code: Demographic Correction Description: Name, DOB, Gender, Etc.

RFI Code: Plan Code Correction Description: Incorrect Plan Selected for Eligibility

RFI Code: Perm Address Description: Address Corrections

RFI Code: ESRD Information Description: Missing Answer to the ESRD Question

RFI Code: Part A and Part B Missing Description: Missing Effective Dates

RFI Code: Updated or Add SNP Verification # Description: Caid Validation Number Not Noted

Certification

2016 Certification

Certification Instructions for the Following Products:

  • Medicare Advantage
  • Medicare Part D

Certification Start Date:

Live

Is AHIP required?

Yes

What is cost of AHIP?

It costs $125 when you access AHIP through the co-branded WellCare/AHIP link. This is a $50 discount off the standard $175 fee.

Can AHIP be used for compliance credit?

Yes

Does Carrier reimburse for AHIP?

WellCare offers a $50 discount off the standard $175 fee when agents access AHIP through the co-branded WellCare/AHIP link.

Certification Product Modules:

Information is currently unavailable.

Certification Compliance Modules:

Information is currently unavailable.

Is face-to-face training required?

No

Will certifying for 2016 allow me to sell 2015 products?

Information is currently unavailable.

Are additional steps required for those certifying for the first time versus those who are re-certifying?

No

How do I retrieve my User Name and Password?

Click on the “Click Here” link after the words “Forgot Password?” to retrieve your password. If you need other assistance, click on the “Click Here” link after the words “For all other types of support and help.”

Who do I contact at Carrier to confirm certification?

You can contact Producer Services at 866-822-1339 or producerservices@wellcare.com.

Certification Web Link:

www.wellcareuniversity.com

Submitting Business

Announcements:

  • WellCare’s 2016 paper applications and sales presentations are available under the “Marketing Tools” tab on the producer portal. If you need sales presentations in another language, please contact producer services.
  • Agents should no longer leave WellCare HIPAA forms and CMS 1696 AOR forms with members as a part of the in-home sales process. To make things easier for their agents and beneficiaries, members will receive these forms in their Welcome Packet.

Application Reminders:

  • The plan year must match the application form year. If they do not match, the application will be denied and a new application must be submitted.
  • 2015 enrollments only use 2015 applications for 11/1 and 12/1 effective dates.
  • 2016 enrollments only use 2016 applications for 1/1 effective dates.

Faxing Applications

When faxing applications, please use the appropriate fax number below.

  • CCP Paper Application: 1-866-473-9124
  • PDP Paper Application: 1-866-388-1521

Paper applications MUST be faxed in within 24 hours of signature. If you fax the paper application, then do not mail it – this can create a problem with your beneficiary’s enrollment.

  • Fax only one beneficiary application at a time. This means you must make a new fax phone call for each and every application. Multiple applications submitted via one fax phone call will result in problems with the enrollment and applications being lost or duplicated, and ultimately, slowed down or rejected.
  • Retain all fax transmittals. You will need to provide the fax transmittal if an application does not get received. Store fax confirmation sheets, fax cover sheets, all original applications, and supporting documents by date in a locked drawer or file.

Scope of Appointment Reminders:

WellCare requires the Scope of Appointment (SOA) to be captured via their Appointment Verification Line (AVL). Agents must cal the AVL for both paper and electronic applications.

  • On the call, agents will either record an SOA with the beneficiary, or request a Paper Scope Exception. If you are granted a paper exception, please fax the SOAto 866-354-8713 within 48 HOURS. Please make sure to retain a copy for your records and possible future audits.
  • If you are doing an immediate AVL, a paper SOA is needed. WellCare accepts the following SOAs: CMS’ generic form, WellCare’s form, and other carriers’ branded forms.
    • WellCare’s 2015-2016 SOA forms can be found on WellCare’s securedproducer portal.
    • Do not fax the paper SOA with the application.

RFI Remediation Line:

Producers can now resolve Enrollment Requests for Information (RFI) by calling a centralized line and providing the necessary information to the representative for immediate correction and submission.

RFI Line: 877-677-5609

The benefits of this line are as follows:

  • Centralized Intake for RFI remediation
  • Reduction in duplicate enrollment submissions
  • Reduction in the RFI remediation timeline
  • Reduced administration to resolve RFI, i.e. duplication of efforts

This process may require the Producer to reach out to the Beneficiary and obtain the updated information and call the RFI line secondarily. Below are the codes and a short description of the information needed to resolve:

RFI Code: HICN Not Found

  • Description: Transposed, missing HICN

RFI Code: Demographic Correction

  • Description: Name, DOB, gender, etc.

RFI Code: Plan Code Correction

  • Description: Incorrect plan selected for eligibility

RFI Code: Perm Address

  • Description: Address Corrections

RFI Code: ESRD Information

  • Description: Missing answer to the ESRD Question

RFI Code: Part A and Part B Missing

  • Description: Missing Effective Dates

RFI Code: Updated or Add SNP Verification #

  • Description: Caid validation number not noted

Commissions

For instructions on how to read your weekly WellCare commissions statement, please go to the Wellcare Website

Supplies

Announcements:

All 2016 starter kits were mailed to active producers. They were sent to the shipping address on file. If you need to replenish your starter kit materials, email producers services with the information below:

  • Your Name
  • Your PID
  • How many kits you need
  • What type of kit you need (PDP or CCP)

How to Order WellCare Supplies:

To order supplies, please email producerservices@wellcare.com. In the email, please include the following information:

  • Agent name
  • Writing number
  • Address to ship supplies to
  • The item(s) needed (brochures, etc.)
  • What state and county the agent would like supplies for or plan id for product
  • Amount needed

How to Find Plan Materials:

Find WellCare’s Summary of Benefits, Annual Notice of Change, Evidence of Coverage, or Multi-Language Insert by using the steps below:

  • Select a State in the upper-right corner of the screen
  • Click “Need a Plan”
  • Click the drop-down arrow by “I am seeking” and select “Prescription Drug Plans”
  • Enter the zip code and click “Search”
  • Select the year that the plan will begin
  • Click “I want to learn about this plan” next to the plan you want to access the materials

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