For Providers

Wellcare by Allwell from MHS provides the tools and support you need to deliver the best quality of care. 

Submit Attestations Online for Chronically Ill Members

Effective January 1, 2023, fax attestations are no longer accepted

Special Supplemental Benefits for Chronically Ill (SSBCI) are offered to Wellcare’s highest-risk members who meet specific criteria for eligibility based on the Centers for Medicare and Medicaid Services (CMS) guidelines. 

Effective January 1, 2023, you can check eligibility requirements and submit attestations on behalf of members online at ssbci.rrd.com.

Steps to determine eligibility, submit attestations and activate benefits

Members are required to schedule an office visit with their doctor or participating physician group for evaluation. Once appointment is made follow the steps below:

1. Visit ssbci.rrd.com.
2. Follow the steps on ssbci.rrd.com to evaluate your patient against the eligibility requirements outlined on ssbci.rrd.com.
3. Submit an attestation form through ssbci.rrd.com indicating your patient meets the eligibility requirements.
4. Submit a claim with the appropriate diagnosis codes from this office visit indicating a member has been diagnosed with one or more qualifying chronic conditions listed on ssbci.rrd.com.
5. Upon receipt of all required information, the member will be sent an approval or denial letter within 10 business days. Approval letters include information on steps the member should follow to activate supplemental member benefits. 

If you have questions regarding the information contained in this update, contact your dedicated Provider Relations Representative with the health plan.

CAHPS and HOS Resources

• CAHPS Resource Guide (PDF)
• Wellcare Provider-Patient Experience (PDF)
• Tips for Improving Patient Experience & Quality of Life (PDF)

Medicare Prior Authorization Summary Change

List effective 7/1/2025

Wellcare By Allwell requires prior authorization (PA) as a condition of payment for many services.  This Notice contains information regarding such prior authorization requirements and is applicable to all Medicare products offered by Wellcare By Allwell.

 Wellcare By Allwell is committed to delivering cost effective quality care to our members.  This effort requires us to ensure that our members receive only treatment that is medically necessary according to current standards of practice.  Prior authorization is a process initiated by the physician in which we verify the medical necessity of a treatment in advance using independent objective medical criteria and/or in network utilization, where applicable.

It is the ordering/prescribing provider’s responsibility to determine which specificcodes require prior authorization. 

 Please verify eligibility and benefits prior to rendering services for all members. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered. NON-PAR PROVIDERS & FACILITIES REQUIRE AUTHORIZATION FOR ALL HMO SERVICES EXCEPT WHERE INDICATED.  

For complete CPT/HCPCS code listing, please see Online Prior Authorization Tool on our website at Wellcare by Allwell PA tool. 

 Effective July 1, 2025, the following are changes to prior authorization requirements: