On December 15, 2012 we launched the new online UM tool that enables a quick and efficient method to submit pre-service review requests for specified procedures/DME that require prior approval, acute inpatient notifications/precertification’s, and discharge notifications. All Wellmark contracting providers, as well as those providers in Iowa and South Dakota, have access to use the new tools.

We will eliminate other existing methods of submission (phone and fax) for these processes effective February 4, 2013 and require all eligible providers to use the new tools for any pre-service review request.

The tool, powered by McKesson’s Clear Coverage, allows you to submit pre-service reviews and notify Wellmark of inpatient admissions and discharges 24/7. Providers needed to begin using the online tools on December 15, 2012, for the following:

• Inpatient acute care admissions and discharges (notification or precertification)
• Procedures requiring prior approval
• Durable/home medical equipment requiring prior approval

The pre-service review Web content is available to you for ongoing updates and communication.