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:
How to find answers to your ICD-10 questions
Raise your hand if you have an ICD-10 question. Well, you’re not the only one. That’s why we created the ICD-10 Web page. Recent updates include additional frequently asked questions and a new best practices page to help you troubleshoot some common reasons for rejection, denials and other issues associated with the transition to ICD-10. Also make sure to check out our ICD Span billing guide. As these and other resources are updated, we’ll let you know via the Wellmark Information Notification System (WINS), so register today if you haven’t already.
ICD-10 claims — paper vs. electronic
Having trouble submitting claims electronically? Don’t drop your rejected claims to paper. Wellmark uses the same criteria for electronic and paper claims. If your claim isn’t accepted electronically, it will also be rejected if submitted on paper. Instead, work with your clearinghouse to identify the problem and resubmit electronically. If you have an inquiry about a specific claim, use the Ask and Track a Question tool for a faster response and the ability to track the status of your inquiries.
Use the most current version of the CMS-1500 form
To comply with ICD-10 and to be consistent with the Centers for Medicare and Medicare Services (CMS), Wellmark is requiring the CMS-1500 form dated February 2012 (02/12) to be filed for all dates of service October 1, 2015 and after. Wellmark will no longer accept any earlier versions of the CMS-1500 after October 1. Any earlier versions received will not be processed by Wellmark and will be returned for resubmission. Check the CMS-1500 form version you are using and update your forms today to avoid returned claims. For more information, refer to the Claims Filing section of the Provider Guide.
New protocols require secure access to Wellmark.com
Effective October 1, 2015, two new protocols will be in place to help save you time and reduce the wait for all callers. Customer service associates will now direct provider callers to the Check a Claim tool for all basic claims-related inquiries. This includes claim status, amount and date paid, name of payee, specific denial reason, etc. In addition, providers will be asked to use the Ask & Track a Question tool for all inquiries related specific to claims. This includes claims corrections, requests for denial review and attachment of supporting documentation. For assistance in using self-service tools, check out the Provider Video Gallery for short how-to videos. If you do not have secure access, please contact your designated security coordinator (DSC).
Revised Provider Guide section now available
The “Credentialing and Network Participation” section of the Provider Guide is now available on the Provider Guide page. Formerly known as the “Contracts and Credentialing” section of the Provider Guide, this revised section will offer you more information about how to apply for and participate in Wellmark networks, as well as enhancements on topics such as providers on active military duty, delegated credentialing, and more! The section also has a new look and feel with reorganized content, increased visuals, and an easy-to-read table with the credentialing and contracting requirements. In addition to the facelift, a few policy changes were made effective October 1, 2015. To check out the revised section and to learn more about the policy changes, go to the Provider Guide page today!
New process maps demonstrate journey
Curious what happens to your credentialing application, recredentialing submission, or change request after it arrives at Wellmark? You asked, and we answered! Wellmark has created three process maps to visually demonstrate the journey your submission takes within Wellmark. Check out the maps today at the bottom of the Credentialing Submission Tracker page or in Appendix G of the Credentialing and Network Participation section of the Provider Guide.
Confused about home health?
Join us October 14 to become the home health expert in your office. During this webinar, you will get an overview of home health, as well as information on the precertification process and tips for billing home health services. Register today to learn more!
New ID cards for members with Medicare supplement policies
Wellmark has issued new ID cards to approximately 177,000 Medicare supplement members with an October 1, 2015 effective date. The new ID cards contain a different member ID number that is preceded by a three-letter prefix. The new member number begins with the letter “W” and is followed by eight digits. The new member ID numbers are a result of an internal change that will help streamline claims and payment processes. Nothing else has changed with the member’s current Medicare supplement plan. Begin using the member’s new ID card and number to verify eligibility, submit claims, etc.