Provider Relations

Increased quality of care and lower medical costs for Wellfleet Workplace health plan members: That’s what our Provider Relations Team delivers.

Wellfleet has direct relationships with multiple PPO networks at both the national and state levels and utilizes these relationships to ensure plan members receive the most appropriate and comprehensive healthcare services available to them.

Payment Guidelines

Assistant Surgeons Not Applicable – Effective through 6/1/2022

Wellfleet Assistant Surgeon List – Effective through 6/1/22

Assistant Surgeons Not Applicable – Effective through 5/31/2021

Assistant Surgeons Not Applicable – Effective through 6/1/2022

Wellfleet Assistant Surgeon List – Effective through 6/1/2022

Drug Screen – Effective through 8/31/2020

Drug Screen – Effective through 8/31/2021

Drug Screen – Effective through 7/31/2022

Experimental and Investigational – Effective through 8/31/20

Experimental and Investigational – Effective through 9/30/2021

Platelet-Rich Plasma Injections – Effective through 5/31/2021

Platelet-Rich Plasma Injections – Effective through 8/31/2022

Platelet-Rich Plasma Injections – Effective through 1/24/2023

Robotic Surgery – Effective through 8/31/2020

Robotic Surgery – Effective through 8/31/2021

Robotic Surgery – Effective through 9/30/2022

Specialty Drug Reimbursement – Effective through 7/31/2023

Attachment A Specialty Drug Reimbursement – Specialty Drug Code List – Effective through 7/31/2023

Specialty Drug Reimbursement – Effective through 9/30/2021

Specialty Drug Reimbursement – Effective 10/1/2021 through 1/31/2022

Experimental and Investigational – Wellfleet Unlisted Code

Unlisted Codes – Effective through 8/31/2022

Unlisted Codes – Effective through 2/28/2023

Vaccine Consultation Fee – CT Plans – Effective through 12/31/2022

Utilization Review Guidelines

Other Provider Resources

To submit a PPO Pricing Inquiry or Appeal, scan and submit all appeal documentation, including a copy of the claim and EOB, to our Provider Relations team.
For a copy of the IRS W9 form and provider sheet, click here.
For questions that cannot be resolved by the network, to submit changes to your IRS W9 form, or to update your provider demographic information, email our Provider Relations team.
Provider Search

To find providers in one of our partner networks, visit the link that corresponds with the logo on your ID card.

1500 Main Street, Suite 1000, Springfield, MA 01115-5369

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Wellfleet is the marketing name used to refer to the insurance and administrative operations of Wellfleet Insurance Company, Wellfleet New York Insurance Company, and Wellfleet Group, LLC. All insurance products are administered or managed by Wellfleet Group, LLC. Product availability is based upon business and/or regulatory approval and may differ among companies.