December 20, 2023
Wellcare has partnered with MCG Health to implement the MCG Cite Guideline Transparency Tool.
Effective January 1, 2024, you can access this feature through the Wellcare Secure Provider Portal.
With the MCG Cite Guideline Transparency Tool, Wellcare can share clinical indications with providers. The tool is a secure resource that helps meet regulations around transparency for care delivery.
Benefits include:
- Transparency: Delivers industry-leading medical determination transparency.
- Access: Allows the review of MCG clinical evidence used by payers to support
member care decisions. - Security: Ensures easy and flexible access via secure web access.
The tool will not affect your process for notifying Wellcare of admissions or for seeking Prior Authorization approval.
To access the MCG tool:
- Login to the Wellcare Secure Provider Portal.
- Select Review Medicare Medical Necessity Criteria located on the “Care Management” tab at the top. This will take you to the MCG Disclaimer page.
- On the Disclaimer page, you must read and Accept Terms and Conditions to proceed to next page.
- Next, you will be required to enter the following:
- First Name
- Last Name
- Category that best fits your interest in the guidelines (select “Provider”)
- Next, choose your preferred way of receiving your access code (text, email, or telephone).
- Once you receive an Access Code, enter it in the MCG website.
- Click on the “caret” in front of the desired guideline category to expand the menu to show all of the guidelines within the selected category.
- Choose the guideline you would like to review from the expanded list.
Important Note:
The tool does not allow you to print the guidelines.
To learn more about MCG or the MCG tool, visit MCG's website or call 1-888-464-4746.
Questions?
If you have any questions, please contact your Wellcare Provider Relations Specialist.
