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Claims and Payment

Discover more about claim filing requirements, reviews, and Wellmark’s payment and coding policies.

    
ICD-10 Diagnosis and Procedure Codes
Stay updated as you prepare for the transition to ICD-10.
  National Provider Identifier (NPI)

Learn how to get your NPI and when to include it on claims.

    
HIPAA 5010

Find the latest information about the new HIPAA 5010 requirements for electronic transactions.

  Submitting Electronic Claims

Find out how to register to submit electronic claims to Wellmark, and learn what happens after you submit a claim.

    
Appeals and Inquiries

Learn about Wellmark’s preservice inquiry and postservice appeal processes.

 

Electronic Transaction/HIPAA Guides 
Learn how to submit various types of claims, and how to check eligibility and benefits, and claims status.

 

Enhanced Ambulatory Patient Groupings (EAPGs) 
Learn about Enhanced Ambulatory Patient Groupings (EAPGs), Wellmark's new outpatient facility payment methodology.

  

View policies for these types of claims:

Important Secure Content

    
Ancillary Claims

Find out the claims filing guidelines for these ancillary services: independent clinical laboratories, durable medical equipment suppliers, and orthotics and prosthetics.

  Treo Website Access Request - Provider Payment 
Access Request form for providers to gain access to the Treo Sharepoint Site which holds Hospital and Facility payment information. 
    

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Related Information

»   Electronic Data Interchange FAQ ;PDF
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