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The document is a Credentialing Application Form for various healthcare practitioners, including independent and collaborative practice professionals. It outlines the necessary information and documentation required for credentialing, such as personal details, professional qualifications, work history, and compliance with regulatory requirements. The form includes an application checklist, sections for additional locations, liability insurance attestation, and a questionnaire regarding the applicant's professional conduct and health status.
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Who is the parent company for Wellcare? Wellcare is a wholly owned subsidiary of Centene Corporation, a leading healthcare enterprise committed to transforming the health of the community, one person at a time.

wellcare credentialing

WellCare-Quick-Reference-Guide-Claims-Submissions-1

Connect Center for physicians offers a web browser for direct data entry (DDE) and the upload ability to submit electronic submissions at no cost to you.

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In this Issue

Be informed of the status of your application upon request by calling the Credentialing. Department at 888.898.7969. Receive notification of the

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Credentialing Alliance FACILITY CREDENTIALING

Your signature is required to complete this application. Facility Name: Name (Please Print):. Title: Signature: Date:

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