Unirse a nuestra red
Unirse a nuestra red
Thank you for your interest in joining WellCare's provider network. If you are submitting this form on behalf of a group, please note that your group only needs to complete and submit this information once. This form is an inquiry for consideration and not an official registration. We will review your request and if we are in need of your specialty, a representative will contact you to help guide you through our formal application process.
Please note: To become enrolled as a Kentucky Participating Provider you must obtain a Kentucky Medicaid ID Number prior to or when completing this form. Please visit Kentucky's Cabinet for Health and Family Services to complete the enrollment form.
Important CAQH Requirements Checklist
Thank you again for your interest in WellCare!
