Participation Agreements for Allied Practitioners

Important Note: If changes are made to the documents, they are null and void.

 

In order to participate in Wellmark's networks, the physician must sign the appropriate agreement(s).

 

If you are ... Then ...
Contracting under a Group, PHO, or PO Complete and print the Provider Agreement Form  (162KB)

Interested in participating in the following Wellmark provider networks

  • Classic Blue
  • Blue Traditions
  • Alliance Select
  • Select First

Complete and return two originals of the Wellmark, Inc. Practitioner Services Agreement  (82KB)

This one agreement includes the networks listed to the left.

Interested in participating in the following Wellmark HMO networks

  • Blue Access
  • Blue Choice
  • Blue Advantage

Chiropractors participate in HMO networks through their affiliation with the Iowa Chiropractic Physicians Clinic (ICPC). ICPC can be contacted by phone at 515-225-0393 or by e-mail at icpc@icpc.net  

Interested in participating in the Wellmark HMO network for the hawk-i program only

  • hawk-i Blue Access

Chiropractors participate in the hawk-i HMO network through their affiliation with the Iowa Chiropractic Physicians Clinic (ICPC). ICPC can be contacted by phone at 515-225-0393 or by e-mail at icpc@icpc.net  for further enrollment information.

 
 
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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota.
 
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