Special Supplemental Benefits
Wellcare Providers: Submit Attestations Online for Chronically Ill Members
Effective January 1, 2023, fax attestations are no longer accepted
Special Supplemental Benefits for Chronically Ill (SSBCI) are offered to Wellcare By Trillium Advantage’s highest-risk members who meet specific criteria for eligibility based on the Centers for Medicare and Medicaid Services (CMS) guidelines.
Effective January 1, 2023, you can check eligibility requirements and submit attestations on behalf of members online.
Steps to determine eligibility, submit attestations and activate benefits
Members are required to schedule an office visit with their doctor or participating physician group for evaluation. Once appointment is made follow the steps below:
- Visit Attestation for Special Supplemental Benefits for the Chronically Ill.
- Follow the steps to evaluate your patient against the eligibility requirements outlined.
- Submit an attestation form indicating your patient meets the eligibility requirements.
- Submit a claim with the appropriate diagnosis codes from this office visit indicating a member has been diagnosed with one or more qualifying chronic conditions listed.
- Upon receipt of all required information, the member will be sent an approval or denial letter within 10 business days. Approval letters include information on steps the member should follow to activate supplemental member benefits.
If you have questions regarding the information contained in this update, contact your dedicated Provider Relations Representative with the health plan.