The Centers for Medicare & Medicaid Services (CMS) regulations require that health plans provide their Special Needs Plan (SNP) provider network with information on their basic Model of Care. This applies to our Dual-eligible Special Needs Plan (D-SNP) members who are eligible for both Medicare and Medicaid, and Chronic Needs members (C-SNP) members who have one or more qualifying conditions.
We have included a self-study program that outlines the basic Model of Care requirements for our providers. Also included are Frequently Asked Questions with other helpful information.
Each year, CMS requires that we educate providers who usually treat our SNP members about WellCare’s Model of Care.
Medicare Provider Expectations – Model of Care
We ask that you partner with us to ensure we are giving the highest quality of care possible to our SNP members by performing the following steps:
- Review the member care plans faxed to you by WellCare
- Update the care plan with any required changes and fax the revised plan back to WellCare at 1-866-287-3286.
a. Call 1-866-635-7045 with questions or to further discuss the care plan.
b. Please keep a copy of the updated care plan to review with the SNP member during the next office visit. - Participate in the Interdisciplinary Care Team (ICT) for all SNP members and give feedback as appropriate.
We appreciate the quality care you provide our members, and your support in our efforts to meet the CMS regulations regarding the SNP Model of Care.