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The Physician Sourcebook is part of our participating provider contract and contains information regarding different aspects of our operations, including the medical management program, billing procedures and your rights and obligations under New jersey law.

Physician Sourcebook

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Reference Guide

Members� Rights & Privacy Information

Physician Responsibilities

Health Services Programs

Precertification and Referrals

Medical Management

Ancillary Services

Quality Management

Claims, Billing & Reimbursement

Complaints, Grievances & Appeals

Sample Forms

E&I List

Privacy Practices

Sourcebook Updates and Administrative Bulletins
Below you'll find a listing of pertinent updates to your Wellchoice Physician Sourcebook. Please contact your provider relations coordinator if you have any questions.

2007 Updates to Physician Sourcebook	Effective Date
NJDOBI Arbitration of Claims Program	Immediately

2006 Updates to Physician Sourcebook	Effective Date
Reimbursement Criteria for Certain Cardiac-Related Services	Immediately

2005 Updates to Physician Sourcebook	Effective Date
NEW! Medical Record Documentation forms make record-keeping easy and compliant with both Wellchoice and New Jersey State Department of Health guidelines.	08/01/05
Introduction of WellChoice Access HMO	6/1/05
Important precertification reminder for outpatient PT/OT services Accompanying list of member prefixes	4/1/05

2004 Updates to Physician Sourcebook	Effective Date
Notice regarding precertification for certain types of radiology services rendered to PPO members	3/1/05
Modification of Physician Fee Schedule	12/1/04
Member's Rights and Responsibilities	Immediately
Notice of Privacy Practices	Immediately
Complaints, Grievances and Appeals	Immediately

2003 Updates to Physician Sourcebook	Effective Date
WellChoice�s updated network of DME suppliers	5/1/03
Reimbursement for outpatient laboratory service	1/1/03

Reference Tools