Training and support
Your dedicated Provider Relations Consultant is available to help you and your associates (ancillary providers, clinicians, vendors, administrative staffs, hospital staffs, and health center staffs) navigate our system and understand our policies and procedures. Your dedicated Provider Relations Consultant will:
- Serve as your main point of contact with WellSense and respond promptly to your questions and concerns
- Provide ongoing education and support
- Create reports at your request
- Help you determine which services are covered and/or require prior authorization
- Work with you to correct claims
- Provider registration process
Learn how to register for a Well Sense Health Plan HealthTrio account.
- Portal overview and basic functionality
Gain an understanding of the portal's basic functionality, including checking member eligibility and claim status.
- Submitting claims
Learn the steps for submitting a claim, how to view the status of a claim, and search for a remittance advice.
- Request for claim review, appeals, corrected claims or credit balance
How to use the Request for Claim Review Form for all EDI claim corrections and claim re-adjudication requests.
Learn how to check member eligibility in our provider portal.
- Office management
Learn how to revalidate account users and add, remove or modify users.
- Prior authorizations (updated 6/23/23)
Learn how to submit prior authorization requests and check the status of your requests.
- Manage member information
Learn how to update various member data online.
Enhancing your communication skills helps you to provide quality care to all your patients regardless of race, ethnicity, or religious beliefs. The resources below can help you assess and improve your cultural competency.
- Cultural competency training - A free, online educational program accredited for physicians, physician assistants, and nurse practitioners. A training program is also available for nurses and social workers.
- New National CLAS standards - An implementation guide from the Office of Minority Health to help you advance health equity and quality for all cultures within your practice or healthcare organization.
- Guide: 12 Steps to Cultural Competency
- Behavioral health providers should call Carelon Behavioral Health at 866-444-5155 for any questions or issues that they may have.
- Durable medical equipment, prosthetic, orthotic and medical supply (DMEPOS) providers should contact Northwood, Inc. at 866-802-6471 for any questions or issues that they may have.
- Radiology providers (not including those associated with observation or ER visits) should contact eviCore at 866-802-6471 with questions or concerns.