Enhancements and Improvements at WellCare of North Carolina: April 2024 Update

We hope this message finds you well. We greatly appreciate the valuable feedback you provided through our recent provider satisfaction survey. Your insights have been instrumental in guiding our efforts to enhance our services and support for you, our valued partners.

We are pleased to announce that we are actively implementing several improvements aimed at making it easier for you to do business with us. Here's a brief overview of the enhancements we're working on:

Improvements to Provider Tools:

We are currently in the process of revamping our Provider website, Provider manual, New Provider Orientation, and developing new training tools. The updated provider website will feature improved navigation, simplified interfaces, and enhanced training resources. These enhancements are scheduled to be completed in the coming months, and we will notify you of their launch through email and through our dedicated Provider Rep team.

Expansion of Operations Team to Support Providers:

To better support you, our providers, we have expanded our Operations team by onboarding seven additional Claims Business Analyst dedicated to addressing claim issues promptly, identifying denial trends and ensuring timely payments to providers. As a result of these efforts, we have successfully improved our claim denial rates to below 10% monthly and reduced turnaround time on claims issue resolution. Moreover, this newly reinforced team is proactively identifying and resolving internal systematic issues before they impact our providers. In collaboration with provider relations this team continues work around provider education on top claim issues.

Enhancements to Member Attribution Process:

We have implemented improvements to our member attribution process to streamline operations and minimize delays. Our Provider Relations (PR) team will now work directly with providers to address any attribution issues and oversee the resolution process to completion. Additionally, we have made internal process changes to eliminate roadblocks that were previously causing delays in processing member moves issues.

Thank you for your ongoing collaboration and commitment to providing exceptional care to our members. Should you have any questions or require further assistance, please do not hesitate to reach out to your designated Provider Representative or contact our Provider Services team at ncproviderrelations@wellcare.com.