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PCP change requests received AFTER the 10th of the month will be effective the FOLLOWING month. KY020112CADFRMENG State Approved 08222012 WC082012317 WellCare 2012 KY0812 48321. Members can continue to be treated by the requested PCP until change is complete. Members should continue to use their current WellCare ID card until they receive their new ID card. All requests will be processed within 7-10 business days of receipt. Part 1 Member Information Please use Legible Print Please provide...

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What is wellcare change pcp form?

Wellcare change pcp form is a form used to request a change in the primary care physician (PCP) within the Wellcare healthcare network.

Who is required to file wellcare change pcp form?

Members of the Wellcare healthcare network who wish to change their primary care physician (PCP) are required to file the wellcare change pcp form.

How to fill out wellcare change pcp form?

To fill out the wellcare change pcp form, provide your personal information such as name, member ID, contact details, and the details of the new PCP you wish to select. Additionally, you may need to provide reasons for the change and any relevant documentation.

What is the purpose of wellcare change pcp form?

The purpose of the wellcare change pcp form is to allow members of the Wellcare healthcare network to request a change in their primary care physician (PCP). This form helps ensure that members receive the most appropriate and personalized care.

What information must be reported on wellcare change pcp form?

The wellcare change pcp form typically requires reporting of the member's personal information (name, member ID, contact details), the details of the current PCP, and the details of the new PCP being requested. Additional information such as reasons for the change and any supporting documentation may also be required.

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