Network Engagement Hot Topics
Health care is a dynamic industry and Wellmark is an equally dynamic company. To keep you updated on the most important changes that affect you, please check this page regularly.
Hot topics for October include:
Thank you for 75 years
Wellmark is celebrating its 75th anniversary this year and to mark this special occasion we want to say “thank you” to our providers with a special video. Whether you’re a doctor, facility manager, nurse, a member of the billing staff, or any one of the many health care professionals who serve our members every day, we thank you for all you do! To learn more about the different ways we’re celebrating 75 years, visit Wellmark75.com.
Track the status of credentialing submissions within seconds
Need to know more about the status of your credentialing submission? Thanks to a new tool on Wellmark.com, you can now get answers within seconds! Effective for all credentialing submissions received after August 31, 2014, the Credentialing Submission Tracker allows you to obtain the current status of your provider applications, recredentialing submissions, and change requests. Simply enter up to 10 national provider identifier (NPI) numbers and you will see the status of your request. This new tool will also display the current average processing time to give you a general idea of when you might expect a final response from Wellmark. Take advantage of this new tool today!
Get more out of Wellmark.com
Join us October 8, 2014 for a webinar focusing on some important tools and resources available on Wellmark.com. The webinar will go beyond the secure applications you use every day to check claim status, benefits, and prior approvals. Rather, we’ll look at some other important resources that do not require a secure login. Register today!
Timely filing guidelines changing
Effective for dates of service on and after January 1, 2015, Wellmark claims must be received within 180 days from the date of service (previously 365 days). This information was included in the contract Amendment Notice sent in October of 2013 with an effective date of February 1, 2014. Wellmark made the decision to delay implementing this part of the amendment to allow providers enough time to prepare for this change. To learn more about timely filing timeframes, refer to the Claims Filing guide.
Inpatient claim search for ACA compliant plans
The option to input additional search criteria when checking a claim (e.g. patient name, date of service, billed amount, etc.) is beneficial when searching amongst multiple claims. In order to locate an inpatient claim for a Wellmark ACA compliant plan, enter the entire date span (to and from dates of service) in the ‘Date of Service’ field. Searching by only the begin date or a single date of service will not return any results.
Attaching an invoice requires paper claim submission
Submitting claims electronically is efficient and saves you time; however, there are some instances when paper submissions are needed due to documentation requirements. For example, claims submitted with breast pump codes E0603 and E0604 require a paper claim with a supporting pricing statement (valid invoice or manufacturer’s suggested retail price [MSRP]). For more information on claims submitted with an invoice or MSRP, refer to the HME, Orthotics, and Prostheses guide.
Having trouble accessing your provider claim remittances (PCRs)?
If you have recently changed your tax identification number (TIN) or terminated from Wellmark networks, you may have trouble accessing your PCRs. In order to access your PCRs, the main designated security coordinator (DSC) for the organization’s TIN must log in at least once every 90 days to maintain web access. By doing so, the claim detail and PCR information will be made available for up to 18 months after the cancellation or TIN change is effective. If your web security has been disabled and needs to be reactivated, please contact WebSecurity@Wellmark.com.
How-to videos now available within tools
Got a question on how to use our online tools? Or perhaps you have new staff members who need training on the tools. If so, we have now added how-to videos within the applications to help save you time! The Check a Claim and Check Member Information tools now have links to instructional videos related to the applications. These videos, along with other how-to videos are also located on the Provider Video Gallery on Wellmark.com.
Stay current with provider guide updates
The Wellmark Provider Guide and specialty guides are billing resources to help you do business with Wellmark. The guides are continually updated to bring you the most current information, so it is important you look at the most current guides on Wellmark.com rather than printing or saving them. To help you identify the changes, the online Provider Guide web page indicates the date the guide was last updated and within the guide, the Summary of Changes page outlines the changes that were made to the guide. To access the most current provider guides, visit the Provider Guides page on Wellmark.com.