If you need assistance during this process, contact our provider application and credentialing area:
To apply to Wellmark, you need to be in an approved location and be an approved provider type for contracting as shown below. To provide services that can be considered for benefits, you must first apply with Wellmark. In its sole discretion, Wellmark reserves the right not to process or accept a provider's application. Wellmark will notify you of your effective date.
After you apply, Wellmark will be able to identify basic information about you when a claim is submitted, such as your National Provider Identifier (NPI), location, provider type, and specialty. Your services will be eligible for coverage beginning with your effective date; services provided prior to that date are not covered.
If approved, you may decide to participate with one or more Wellmark networks. If you are interested in participation, you need to complete Step 3. You will find a list of participation advantages under Step 2.
Your location determines whether or not you are eligible to apply and to participate with Wellmark. If you are eligible based on location, you must also be an approved provider type for contracting. If you are an approved provider type for contracting, and:
Note: Independent Clinical Laboratories, Durable/Home Medical Equipment Suppliers and Orthotic and Prosthetic Suppliers do not have to be physically located in South Dakota or in a county bordering to South Dakota to participate in Wellmark's Indemnity, PPO, TPA, and HMO networks. See the ancillary claims information regarding claims filing rules for these provider types. Continue the enrollment process in Step 2.
If you are one of the following approved provider type for contracting, your practice location will determine whether or not you are eligible to apply and participate with Wellmark.
Note: Wellmark is not accepting applications from home infusion therapy (HIT) providers for participation in the provider networks. HIT providers may complete an application for consideration as non-participating.
If you decide not to participate but wish to provide services that are eligible for benefit consideration, you must apply to Wellmark and provide services after your effective date with Wellmark begins. Wellmark will send you your effective date after your application is processed.
Avoid completing unnecessary paperwork or processing delays by reviewing the following tips.
You can participate with Wellmark by location or through a corporate contract. Wellmark considers a corporation any organization that owns four or more sites of the same type within Iowa or South Dakota.
Wellmark strongly encourages out-of-state independent clinical laboratories and durable medical equipment suppliers to sign both Iowa and South Dakota provider agreements. Out-of-state providers who sign with Wellmark will be added to the Wellmark provider directories as in-network for both Iowa and South Dakota members.
To locate participation agreements for which you may be eligible, select your provider type, then Go:
Note: To avoid delays in processing your application or contract, please access updated documents using the links below. Please dispose of any paper stockpile you may have. Wellmark's contracts have been updated to reflect a change in signature authority, while other addendums or applications now request additional information.
Send the application and accompanying documents to: