Provider Manual

• 2025 Wellcare by Allwell Provider and Billing Manual (PDF)
• 2024 Wellcare by Allwell Provider and Billing Manual (PDF)

Provider Forms

• Inpatient Authorization Form (PDF)
• Outpatient Authorization Form (PDF)
• Outpatient Authorization Supplemental Form (PDF) 
  • This is an optional page meant to be used in conjunction with the Sunflower's Outpatient Prior Authorization Request form when a request exceeds more than four procedure codes. This page should never be submitted alone.
• Electroconvulsive Therapy (ECT) Authorization Request Form (PDF)
• Inpatient Neuropsychological Testing Authorization Request Form (PDF)
• Outpatient Psychological Testing Authorization Request Form (PDF)
• Outpatient Treatment Request Form (PDF)
• Transcranial Magnetic Stimulation (TMS) Request Form (PDF)
• SSBCI Attestations for Chronically Ill Members
• Non-Par Provider Appeal Form (PDF)
• Par Provider Payment Reconsideration Form (PDF)

Other Resources

• Clinical & Payment Policies
• QMB Balance Billing FAQs - information about balance billing qualified medicare beneficiaries
• Sunflower Member ID Card Reference Sheet (PDF)
• Medicare Step Therapy Clinical Policy (PDF)
• Premier Eye Care Provider Manual (PDF)
• Medical Necessity Criteria
• Timely Filing Guide
• 2025 Alternative Covered Drugs (PDF)

Training Resources

Training & Education

Orientation Resources

• Wellcare By Allwell Orientation Presentation
• Wellcare By Allwell Booklet Provider Guide (PDF)
• Wellcare By Allwell Payspan (Electronic Funds Transfer) (PDF)
• Wellcare By Allwell Prior Authorization Guide (PDF)
• Wellcare By Allwell Risk Adjustment Tips (PDF)
• Wellcare By Allwell Secure Provider Portal (PDF)
• Wellcare By Allwell Quick Reference Guide (PDF)
• Wellcare By Allwell Claim Reconsideration and Dispute Reference Guide (PDF) - Updated Jan. 26, 2024