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 December include:
Reminder: Timely filing guidelines change January 1, 2015
Claims for dates of service through December 31, 2014 will fall under the current 365-day timely filing guideline. However, beginning with dates of service on or after January 1, 2015, claims must be received within 180 days from the date of service. This change will not impact the timelines associated with Federal Employee Program (FEP) members, coordination of benefits, provider inquiries, appeals, denials, and adjustments. To learn more about specific timely filing requirements, refer to pages 19-20 of the Claims Filing provider guide.
Ten months to prepare for an overnight change
October 1, 2015 may seem far away. But when you consider the impact of the switchover to ICD-10, this date is just around the corner. With the increased granularity of coding that ICD-10 will provide, the key to adapting is to prepare now. The good news is that more specific documentation in coding will benefit both you and your patients. To learn more, visit the Centers for Medicare and Medicaid Services' Road to 10 website. This online resource was built with the help of providers in small practices, and is designed to help small medical practices jumpstart their ICD-10 transition. To learn how Wellmark is preparing to meet the compliance timeframes, visit the ICD-10 page.
Streamlined search options help you find your claims
After careful analysis to determine the most efficient way to find pended claims, Wellmark has made some changes to the Check a Claim tool’s interface. Specifically, we discovered providers were most successful in finding what they need when using two key search criteria – Billing Provider Number and Date of Service. Now, only those two fields are displayed. This also helps reduce confusion between the Member Claim Search and the Provider Pended Claim Search options. If you have the claim number and patient information, simply use the Member Claim Search option. Otherwise, use the Provider Pended Claim Search to generate a list of your claims that are being processed.
New year, new products
Join us on December 10, 2014 for a webinar to prepare you for product changes in the upcoming year. This webinar will focus on the networks, benefits, and requirements associated with the 2015 products. With the exception of the new Wellmark Blue RewardsSM products, Wellmark’s products underwent relatively few changes and additions. Although these changes are minimal, there are key points to watch for that will make your administrative processes smoother and easier. Register today to learn more!
Start the new year off paperless
If you have not enrolled in electronic fund transfer (EFT), now is the time. EFT is a method by which Wellmark electronically reimburses providers for their claims. By signing up for EFT, you will be able to receive payments faster and eliminate the clutter of paper checks. You will also have the ability to match the payment to your provider claim remittance (PCR) sooner! To sign up or change enrollment, use our Electronic Funds Transfer (EFT) Form. Please note, you must have secure access to Wellmark.com in order to submit the form. If you have any questions, check out our Frequently Asked Questions document. Enroll today and be more efficient in 2015!