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Step 1: Determining EligibilityTo contract with Wellmark and provide services that can be considered for benefits, your facility/entity needs to be:
1) In an eligible location. 2) An eligible facility/entity type.
Eligible Locations:
a. If the answer is "yes" to at least one network, you may continue through the enrollment process.
Eligible Facility/Entity Types:
Providers can participate in none, some, or all of Wellmark’s provider networks, and in the TRICARE network. The TRICARE network also covers members from the Department of Veteran's Affairs and the Civilian Health and Medical Program of the Department of Veteran's Affairs (CHAMPVA). To learn more about the TRICARE program, visit the TriWest Web site
Even if you don't participate in our networks, as long as you are enrolled, you can provide payable services to Wellmark members. Step 2: Using the Correct Enrollment FormsNote: 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.
Wellmark accepts the Facility Application #S-2325
Also submit these forms:
Time-Saving Tips Wellmark accepts participation applications you've completed for other insurers as long as:
For faster processing of your application:
Step 3: Obtaining Your Participation AgreementsFacilities and Entities can enroll with Wellmark individually, through a corporate agreement, or an agreement made by your Provider Hospital Organization (PHO). A corporate agreement will be offered to an organization that owns four or more facilities or entities of the same type in eligible locations. If your organization is interested in a corporate agreement, contact Network Relations at 515-376-5167 (Iowa) or 800-700-9137 (South Dakota).
Get the participation agreement designed for your facility/entity type:
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. Step 4: Submitting Your FormsSend the application and accompanying documents to: |
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