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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 6/1/2021
• Wellfleet Assistant Surgeon List
• Drug Screen – Effective 10/1/2021
• Experimental and Investigational – Effective 10/1/2021
• Attachment A Experimental and Investigational — Wellfleet Unlisted Code — Effective 10/1/2021
• Attachment B Experimental and Investigational — Wellfleet E-I Code — Effective 10/1/2021
• Platelet-Rich Plasma Injections – Effective 6/1/2021
• Robotic Surgery – Effective 10/1/2021
• Specialty Drug Reimbursement – Effective 2/1/2022
• Attachment A Specialty Drug Reimbursement – Specialty Drug Code List – Effective 2/1/2022
• Assistant Surgeons Not Applicable – Effective through 5/31/2021
• Drug Screen – Effective through 8/31/2020
• Drug Screen – Effective 9/1/2020
• Experimental and Investigational – Effective through 8/31/20
• Experimental and Investigational – Effective 9/1/2020
• Experimental and Investigational – Wellfleet E-I Code
• Experimental and Investigational – Wellfleet Unlisted Code
• Platelet-Rich Plasma Injections – Effective through 5/31/2021
• Robotic Surgery – Effective through 8/31/20
• Robotic Surgery – Effective 9/1/2020
• Specialty Drug Reimbursement – Effective through 9/30/21
• Specialty Drug Reimbursement – Effective 10/1/2021 through 1/31/2022
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.