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WellCare Transition

June 28, 2011

This is to inform you that effective August 1, 2011; the administrative functions that were performed by Med3000 for HFNI in reference to the WellCare Medicare Advantage contract are transferring from Med3000 back to WellCare. Below is a letter from WellCare informing the WellCare participating providers of the change including Frequently Asked Questions detailing what to do for some of the changes.

Also, effective August 1, 2011 the nature of the contract between HFNI and WellCare will change. Since inception, HFNI has had a risk based contract with WellCare. HFNI was given a capitation and we managed to that amount. This means we made or lost money on that capitation amount. This contract has existed since May 1, 2002. On August 1, 2011 HFNI will switch to a messenger model contract and WellCare will purchase some administrative services from us. These services include Network Assistance, Delegated Credentialing, Case Management/Medical Home and Risk Adjusted Payment System Cooperation. As you can tell from the services, the local providers, through HFNI, will still be involved in the manner in which care is delivered for this product. Since it is a messenger model, you will be asked to opt-in the product again. This will not cause any change in your current reimbursement or in your status as a participating provider in the WellCare Medicare Advantage product as previously defined in the WellCare Joinder you have already signed. Look for the opt-in document shortly.

We will continually update the Frequently Asked Questions and get this to you via email and also post it out on our website. We expect the next group of questions to cover medical management issues.

WellCare Letter to Physicians including Frequently Asked Questions


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