Services - Overview
WellMed Medical Management, Inc., a San Antonio-based practice management company, offers various types of services to its contracted providers such as Disease Management, Contracting, Credentialing, Utilization Management, Case Management and Physician Recruitment to name a few. We encourage you to read about these services on our website and to contact us for any questions or issues you may have. We feel the more you have access to through this website as a resource, the better you will understand what we can provide to your operational needs and delivery of health care.
Contracting Overview
The WellMed Contracting Department is responsible for establishing and revising new as well as existing physician contracts which includes primary care physicians, specialists, hospitals and ancillary providers.
Our contracts also include office leasing and personnel placement.
Questions regarding contracting issues may be directed to contracthelpdesk@wellmed.net or you may call (210) 617-4017.
Utilization Managment Overview
The WellMed Utilization Department is responsible for the compliance and monitoring of the referral process for requested patient benefits to ensure timelines are met in accordance with state and federal guidelines.
Questions regarding patient referrals and/or benefit coverage clarification may be directed to umhelptdesk@wellmed.net.
Case Managment Overview
Case Management falls under the Utilization Management Department umbrella. Case Managers work collaboratively with the Primary Care and Specialist Physicians to develop a plan of care for the member in conjunction with the appropriate healthcare resources.
The Case Manager facilitates communication and coordination of care between all members of the healthcare team involving the patient and family in the decision making process in order to promote a team approach with a primary focus on discharge planning. The Case Manager educates the patient and all members of the health care delivery team about case management, community resources, insurance benefits, and cost factors so that informed decisions can be made.
Questions regarding patient referrals and/or benefit coverage clarification may be directed to umhelptdesk@wellmed.net.
Credentialing Overview
WellMed has its own Credentialing Department who is responsible for ensuring that all of our contracted, new and existing, physicians are licensed in accordance to the state of Texas. This includes initial credentialing process, re-credentialing, and licensure tracking. The credentialing systems and files are kept secured for privacy purposes. The Credentialing Committee meets monthly to review and approved physician file information.
Should you have any questions or need clarification regarding Credentialing issues, you may contact Kathy Alonzo at (210) 949-4121 or email her at kalonzo@wellmed.net.
Claims Overview
The WellMed Claims Department processes claims exclusively for Secure Horizons members in the San Antonio area. All claims are processed in accordance to federal and state guidelines, as well as guidelines mandated by the health plan. All checks and explanations of benefits paid by WellMed are created and mailed out from our WellMed Corporate Office.
Should you have claims questions or need assistance regarding a claim, the Customer Service Team for the WellMed Claims Department can be reached at (210) 617-4099 or the email contact is claimshelpdesk@wellmed.net.
Physician Services
The WellMed Physician Services Department is responsible for:
Questions regarding physician issues or physician requests for education may be directed to contracthelpdesk@wellmed.net, phone number is (210) 617-4083 and fax number is 671-4091.
