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Medical Policies and Authorizations


Pre-service Review for Out-of-Area Members

Includes notification, pre-certification, pre-authorization and prior approval.


Get the forms you need to obtain a review for medical necessity, and learn about Wellmark member requirements and Federal Employee Program (FEP) member requirements.

Important Authorization Terms

Find out the difference between the various types of authorizations, and learn how and when to get the approvals you need.


Medical Policies
Determine what treatment, procedure, service or supply may be eligible for coverage.



Quick Links

» Authorization Table
» Credentialing Submission Tracker
» Drug Information
» Education
» Find a Doctor or Hospital
» Forms
» Health Care Reform
» ICD-10
» Medical Policies
» Provider Guide

Related Information

» Prior Authorization and Treatment Request Forms
» Radiology Pre-Service Appeal/Post-Service Inquiry Process
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