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Practice Guidelines

Preventive and clinical practice guidelines are based on the health needs and opportunities for improvement identified as part of the Quality Assurance Program Improvement (QAPI) program. Whenever possible, Arizona Complete Health adopts preventive and clinical practice guidelines that are published by nationally recognized organizations or government institutions as well as state-wide collaborative and/or a consensus of healthcare professionals in the applicable field.

Practice Guidelines

Adopted Clinical Practice and Preventative Health Guidelines (PDF) - (Marketplace, Medicaid, Medicare)

The Centers for Medicare & Medicaid Services (CMS) requires health plans to provide annual education and training on Wellcare’s Model of Care to providers who treat members on our Special Needs Plans. This applies to our Dual Eligible Special Needs Plan (D-SNP) members, who are eligible for both Medicare and Medicaid, and our Chronic Condition Special Needs Plan (C-SNP) members, who have one or more qualifying conditions.

As documented in our Provider Manual, all providers who treat Special Needs Plan (SNP) members must complete Wellcare’s Model of Care training. Below is the provider training material updated annually to align with the current year Model of Care. Included is the self-study training that outlines Wellcare’s Model of Care requirements for our providers.

For additional information on how to work with us to serve SNP members, please visit the Provider Resources page to find links to the provider manual and other tools.

We appreciate the quality care you provide to our members and your support of our efforts to meet Medicare requirements.

Member Resources for Peripartum and Postpartum Depression

Alcohol and Other Drug (AOD) Toolkit

Suicide Prevention

Suicide Prevention Hotlines