Attention WellMed HMO Patients; as of October 1, 2024 WellMed will no longer authorize visits or procedures with Spine & Joint Pain Specialists. We are not in network with WellMed at this time.
Attention WellMed HMO Policy Holders
Specialists Referral Information for WellMed Patients
As the Public Health Emergency referral waiver was lifted in 2023; WellMed opted to extend the waiver through 9/30/24. Beginning 10/1/2024, all Primary Care Providers (PCP) who manage any WellMed patient should begin to issue referrals for specialty care.
WellMed believes patient care starts with the PCP. Our approach ensures no patient is left behind and that they receive personalized coordinated care to ensure the best outcomes.
Implementation Period Starting 10/1/24
WellMed’s implementation period is intended to minimize disruption to provider offices and patients. This will allow provider offices to adjust to the process of receiving referrals for WellMed patients for specialty care. During this period, WellMed is encouraging all providers to establish a connection through LeadingReach:
- WellMed PCPs will be submitting referrals through the LeadingReach
- Specialists will receive a referral from a WellMed PCP via If a referral is not received, the specialist should request a referral from the PCP.
What is LeadingReach?
LeadingReach is a web-based platform enabling more streamlined care coordination. WellMed has joined with LeadingReach to provide world class referral management services that will assist providers in coordinating the right care, in the right place, at the right time.
Additional information about LeadingReach:
Go to https://leadingreach.com/WellMed/ and select “Schedule a Demo” or “Join the Network” to request outreach by LeadingReach.
How to Validate a Referral:
Please review the LeadingReach system to validate a referral has been obtained. If the approved referral is not in LeadingReach please contact the patient’s PCP PRIOR to any appointment scheduling of a WellMed patient.
Claims Submissions:
- Specialist must verify that the referral has been approved through the LeadingReach system
- Include LeadingReach referral number on the submitted claim
Go to https://leadingreach.com/zephyr/specialist for questions about registering, accessing the portal, or training opportunities. If you have any further questions please contact WellMed Provider Service at ProviderService@WellMed.net.