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Carrier Updates

Wellcare is going to re-issue 100% of all ID cards for every line of business in New York (HMO, PPO, and PFFS). As of Monday, January 28th, they are projecting in-home dates ranging from 1/28 to 2/1 with the expectation that PPO and PFFS members will be in the earlier part of that window. 

WellCare is also working with their call center teams to push out an IVR message to every active member in the state notifying them a new card is on its way and when they should receive it by which should begin complete by the end of this week.

  • As a reminder, WellCare no longer prints the PCP on the ID cards for their PPO members. For your members that had previously received ID cards with the correct PCP listed on them, please communicate to them WellCare's policy change and that the change to the ID card in no way impacts their ability to visit their previously selected PCP.
  • WellCare is working with IT on a list of all returned mail to ensure this is not potentially impacting this particularly issue. 
  • WellCare is also working to develop local access to the PDF of all ID cards that have been tagged and sent. This process is not fully stood up yet, but they hope to have that in the coming days to allow our local teams to send the cards for the members that have been escalated to them. 
  • As WellCare implements all of these steps above, should the timelines or updates change at all they will update you. 

Access to Care issues: As previously communicated, please send any access to care issues to [email protected] as quickly as possible. WellCare continues to have a team of dedicated resources on stand-by to address these issues as they come in and are currently resolving the majority of issues within a couple of hours. 

Provider Relations/Network Management: WellCare's Network leadership team continues to aggressively outreach to the highest volume providers. If you are hearing of specific practices in need of education or outreach, please send them either to the inbox above or to our one of their local network leaders.

RFI Status and Rejected Applications: WellCare has run a full reconciliation of every application currently still in “Pending” status due to an RFI, or that ultimately was a rejected application. They will be delivering this list to each agency in the coming 24 hours. Their local team will also be working through each of these as well and is available as a resource to assist you in any way possible. 

Ancillary Benefits Quick Reference Guide: Attached is their first draft of a document to be able to assist members in accessing many of the core ancillary benefits. WellCare will continue to evolve this document with your feedback as they go forward. 

Please look for another update next week with a status on each of the items above, along with a number of other areas they are still working through (Agent of Record policy, updates on Call Center performance, Additional resources for their escalation process, a revised Producer services model etc).