Wells Templates

The Wells templates listed below are divided into two main groups: 1) templates to be used by managed care entities (those contractors governed by the Code of Federal Regulations) and 2) all other contractors. The templates are similar, but vary slightly based on managed care requirements outlined in the CFR that do not apply to other contractors. Managed care entities include the Healthy Louisiana managed care organizations (MCOs) and the dental pre-paid ambulatory health plan (PAHP).  

Templates for use by MCOs and the Dental PAHP ONLY

Templates for use by Non-Managed Care Contractors ONLY