Medicare Provider Resources
Wellcare By Allwell
Wellcare By Allwell is Sunflower's Medicare Advantage plan. Use the resources below for all plans EXCEPT Wellcare Complete.
Medicare Provider Service
Providers can send us their questions related to Wellcare By Allwell (Medicare Advantage) through the secure portal messaging function or by using this form.
Provider Manual
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 Part B Drug List (PDF) - Effective Jan. 1, 2023
- Premier Eye Care Provider Manual (PDF)
- Medical Necessity Criteria
- Timely Filing Guide
Training Resources
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
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Medicare Provider News
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