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  • 8735 Henderson Rd Tampa Fl 33634

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Please complete the 2011 Enrollment Form and return to: WellCare P.O. Box 31411 Tampa, FL 33631-3411 If you have any questions, please contact Customer Service at 1-866-765-4390 (TTY users should.

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Claims Department PO Box 31224 Tampa, FL 33631-3224 The Claim Payment Dispute process is designed to address claims when there is disagreement regarding reimbursement. Claim payment disputes must be submitted to WellCare in writing within 90 days of the date of denial on the EOP.

Attn: Appeals Department, P.O. Box 31368 Tampa, FL 33631-3368. This form is to be used when you want to appeal a claim or authorization denial. Fill out the form completely and keep a copy for your records. Send this form with all pertinent medical documentation to support the request to WellCare Health Plans, Inc.

Providers must use the WellCare payer id 14163 if choosing to use Connect Center free DDE or batch upload services.

Urgent Authorizations and Provider Services: 1-888-333-8641 *Please refer to Coastal Care Services, Inc.

As of January 1, 2019, only standard claim forms (red dropout ink) may be mailed to P.O. Box 31372, Tampa, FL 33631-3372.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232