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Wellcare By Allwell Appeal Form Web request for redetermination of medicare prescription drug denial fill out and submit this form to request an appeal for medicare medications. You may file an expedited (fast) appeal by calling member services. Web wellcare by allwell requires a copy of the completed and signed appointment of representative form to process an appeal filed by the member’s representative. Send this form with all pertinent medical documentation to. Web wellcare by allwell requires a copy of the completed and signed appointment of representative form to process an appeal filed by the member’s representative.
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