If you are impacted by the Change Healthcare outage, please visit our website for further information


Wellcare is ready to become your Medicare partner!

The Annual Enrollment Period for your Medicare patients runs from October 15 to December 7. Your patients have a choice in their Medicare health insurance, and we hope that they will use this Annual Enrollment Period to get acquainted with Wellcare. If they ask you about their coverage options, let them know you accept Wellcare.

As our partner, you can count on our complete support as you continue to focus on providing compassionate and expert care to your patients. Our most helpful provider resources include:

Further provider resources, including dedicated Provider Relations and Contracting contacts, can be found on the Nebraska Total Care’s website at www.nebraskatotalcare.com/providers.html. Wellcare is the Medicare product offered through Nebraska Total Care.

Questions?

Submit Attestations Online for Chronically Ill Members

Effective January 1, 2023, fax attestations are no longer accepted

Special Supplemental Benefits for Chronically Ill (SSBCI) are offered to Wellcare’s highest-risk members who meet specific criteria for eligibility based on the Centers for Medicare and Medicaid Services (CMS) guidelines. 

Effective January 1, 2023, you can check eligibility requirements and submit attestations on behalf of members online at ssbci.rrd.com.

Steps to determine eligibility, submit attestations and activate benefits

Members are required to schedule an office visit with their doctor or participating physician group for evaluation. Once appointment is made follow the steps below:

  1. Visit ssbci.rrd.com.
  2. Follow the steps on ssbci.rrd.com to evaluate your patient against the eligibility requirements outlined on ssbci.rrd.com.
  3. Submit an attestation form through ssbci.rrd.com indicating your patient meets the eligibility requirements.
  4. Submit a claim with the appropriate diagnosis codes from this office visit indicating a member has been diagnosed with one or more qualifying chronic conditions listed on ssbci.rrd.com.
  5. Upon receipt of all required information, the member will be sent an approval or denial letter within 10 business days. Approval letters include information on steps the member should follow to activate supplemental member benefits. 

If you have questions regarding the information contained in this update, contact your dedicated Provider Relations Representative with the health plan.

Clinical Policy List

For Medicare information, please visit our Medicare Prior Authorization website.

A-G H-P Q-Z
     
District Procedural Service: Modifier 59 (PDF)   Robotic Surgery (PDF)
Effective Date: 1/1/2022