RxEffect Bonus Incentive for Wellcare and Wellcare By Fidelis Care Providers
8/9/2022
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Posted by Provider Relations
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:
- Diabetes
- Blood Pressure
- Cholesterol
Incentive Payment Program Criteria:
This Incentive Payment Program offers $50 per Qualifying Member Therapy (max of $150 per member depending on number of therapy areas) between August 11, 2022 through December 31, 2022. 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 2022.
- “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 2022.
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 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 2023 Wellcare by Fidelis Care supplemental payments distributed in May 2023.
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 or Provider Relations Specialist through any of our regional office numbers.