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Web wellcare by allwell requires a copy of the completed and signed appointment of representative form to. Web use this form as part of the wellcare by allwell request for reconsideration and claim dispute process. Web last updated on: A repository of medicare forms and documents for wellcare providers, covering topics. Web we're here for you. Web send this form with all pertinent medical documentation to support the request to wellcare health plans, inc. A repository of medicare forms and. Web medicare pharmacy appeals p.o. Web wellcare by allwell requires a copy of the completed and signed appointment of representative form to.