WellCare has created several educational resources for providers.
Fluoride Varnish Training Tool
WellCare provides fluoride varnish training for PCPs who service the pediatric population 0-5 years of age. Below is a link to a Smiles for Life training course: Caries Risk Assessment, Fluoride Varnish and Counseling. This course focuses on early childhood caries and prevention. It includes information on the benefits, safety precautions, and dosing for fluoride as a comprehensive approach to a child's oral health.
- Smiles For Life is a National Oral Health Curriculum Educational Training Tool for our participating PCPs.
- Credit: Dr. Joanna Douglass and Smiles for Life National Oral Health Curriculum - Fluoride Varnish Module
- Smiles for Life - Flouride Varnish Training Tool (PDF)
- Fax your completed Fluoride Varnish Application Attestation Form (PDF) to 813-865-6759.
As a reminder, application of fluoride varnish by a PCP is reimbursed in addition to the office visit when:
- Fluoride varnish is applied by any trained medical staff. The physician must be trained and submit attestation that all staff providing the service have been trained and will be supervised.
- Fluoride varnish application will be combined with a risk assessment, anticipatory guidance, and referral to a dentist that treats children under the age of five (5) and will be linked to the well child visits for children through the age of five (5).
- NJ Smiles Directory (Under section labeled Helpful NJ FamilyCare Information tab: "Dental Providers for Children")
- These three services will be reimbursed as an all-inclusive service billed using CPT code 99188 and ICD-10 code Z41.8 and can be provided up to four (4) times a year. This frequency does not affect the frequency of this service at by the dentist.
- A bi-directional referral to the dentist is a requirement of the program, document referral in medical record. The referral process requires communication between Primary Care Providers and Primary Care Dentists. Bi-directional forms for dental referrals are available on the WellCare website: Bi-directional forms (PDF).
**Important: A referral to a dentist by one year of age or soon after the eruption of the primary tooth is mandatory. Follow up child visits to determine at minimum dental visits twice a year for oral evaluation and preventive services occurred and that needed treatment services are being or were provided.
Hands on training can be scheduled by contacting the Program Director for Oral Health from the NJ Chapter American Academy of Pediatrics at 609-631-5738.
If you need assistance referring a member to the dentist, please contact the Dental Vendor Program Admin at 973-274-2157.
Fraud, Waste and Abuse Training
The Centers for Medicare & Medicaid Services (CMS) requires all delegated and contractual Medicare Part C and Part D providers to complete fraud, waste and abuse (FWA) training. The training is available online (PDF) for WellCare providers.
- Provider Training Calendar BH/MLTSS/DSNP (PDF)
- Provider Training Calendar MLTSS (PDF)
- Provider Training Calendar BH/PIP/Autism (PDF)
- Adult Day Care Services Training (PDF)
- Provider Relations Training (PDF)
- Provider Fraud Training (PDF)
- Bidirectional Tool Kit (PDF)
- Provider Fluoride Varnish Tool Kit (PDF)
- PCP Fluoride Varnish Application Update (PDF)