RxEffect Bonus Incentive for Participating Providers Treating Wellcare and Wellcare By Fidelis Care Members
8/19/2024
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Posted by Provider Relations
in
Provider News,
Provider Quality
As part of a year-end push to improve medication adherence, WellCare and WellCare By Fidelis Care are offering an additional financial incentive (Incentive Payment Program) to its providers who use RxEffect® to identify and take action in the following Star ratings medication therapy areas in the treatment of their Wellcare and Wellcare By Fidelis Care members:
- Diabetes
- Blood Pressure
- Cholesterol
Incentive Payment Program Criteria:
This Incentive Payment Program offers $200 per Qualifying Member Therapy (max of $600 per member depending on number of therapy areas) between August 8 , 2024 through December 31, 2024 . The Bonus is based on Eligible Members getting their last medication fill for end of year adherence, and is broken into two categories:
- “90-Day Conversion” – The Bonus icon will appear for member therapies converted from a 30-day fill to a 90-day fill that makes the Eligible Member adherent for that therapy in 2024 .
- “Last Fill” – The Bonus icon will appear for Eligible Member therapies that need one fill to meet the Eligible Member’s adherence goals for that therapy in 2024 .
Bonus eligibility is dynamic and will be updated weekly. Please note: While a Qualifying Member Therapy may be eligible for each of the Bonus types through year-end, only one Bonus will be active at a time and therefore only one Bonus will be paid per therapy.
Incentive Payment Program Eligibility:
To receive your Bonus, you must take the following steps:
- Visit www.RxEffect.com to review the Qualifying Member Therapies eligible to receive a Bonus.
- The patient list must be viewed while the therapy is eligible to receive a payment.
- Help ensure the Eligible Member meets adherence criteria by filling a pharmacy claim through their WellCare prescription benefit (without a claim reversal) for that therapy area while eligible for the Bonus (displaying the Bonus icon).
Incentive Payment Program Payout:
Incentive Payment Program payout will be included as a separate line item for 2025 supplemental payments distributed in May 2025.
For a more detailed description of the Incentive Program, including how to identify bonus opportunities in RxEffect, please click here for more details.
If you do not currently have access to RxEffect, please contact help@RxEffect.com. If you have questions about the bonus program, please contact your Provider Partnership Associate. To find your designated representative, please visit Contact Provider Relations on our website.