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Working with Wellmark.com

Welcome to Working with Wellmark.com, your source for news, information and tips for making the most of the resources available on our secure provider website. This page is designed for all providers with secure access to Wellmark.com. General users will learn about easy-to-use Web tools, while designated security coordinators (DSCs) will learn how to manage security roles within their organization.

InnovationMonthly Quick Tip

Right click trick

In June, the Working with Wellmark.com page showed you how to avoid having to “start over” with a claim or member search by simply using the drop down menus in our secure tools. This month, we offer another tip to increase your efficiency. Let’s say you’re working in the Check a Claim tool and your screen shows several claims for a particular member. As you know, clicking one claim number will take you to the “Claim Status” screen. But what if you want to open up two claims and compare them in separate windows? Easy! Just right click on the claim number and select “Open in New Window.” This works with almost all of the links in our online tools. Log in to the secure provider tab of Wellmark.com and try this little trick today!

NewsNews

Are we meeting your needs?

The entire purpose of the secure provider pages on Wellmark.com is to serve you, our providers. During the next month or so, you’ll be invited to let us know whether these pages are, in fact, meeting your needs. After logging in to our secure site, you may be asked to participate in a very brief, anonymous survey. It only takes two or three minutes, but this small investment of your time is invaluable to us. Your feedback will help ensure that our website makes it easy for you to do business with Wellmark. Note: most users will be invited to complete the short survey only once. If you delete your internet cookies, however, you may be asked again. In that case, simply decline the invitation. Thanks in advance, and we look forward to hearing from you so we can improve your online experience!

 

Let us be your guide!

Having trouble getting a claim to process? The Wellmark Claims Filing pdf guide can help. Need to know how to bill home medical equipment? Check out our HME, Orthotics, and Prostheses pdf guide. Want to understand more about how iCAP edits work? Our guide to Outpatient Services pdf has the information you need. Whatever your question — from credentialing to specialty services to billing — the Wellmark Provider Guides are a great place to start. To ensure you’re accessing the most up-to-date version of any of our 19 topic-specific guides, bookmark this page today!

 

New requirement helps improve efficiency 

Did you know that clinical documentation for continued stay review can be easily submitted through Wellmark’s Utilization Management tool? Thanks to this enhancement, providers no longer need to fax this information. In fact, this system is working so well, Wellmark will discontinue the current fax functionality for Iowa and South Dakota providers effective Sept. 1, 2014. To ensure that you are able to access the Utilization Management tool to complete this task, please speak to a designated security coordinator in your organization so that he or she might provide you with the appropriate security role. Specifically, you will need access to the “Utilization Management - Inpatient Notification” role.

 

New varicose vein policy may require DSC attention

Do providers in your practice treat varicose veins? If so, please know that Wellmark coverage for certain varicose vein procedures will be subject to InterQual® criteria and prior approval requirements beginning with dates of service Sept. 15, 2014. Please ask your DSC to prepare now by determining who in your organization will be completing requests for prior approvals. Then, use the User Maintenance Tool to make sure these individuals have been assigned the appropriate security roles to access the Wellmark Utilization Management Tool.

Secure Web ToolsWeb Tools and How-to Videos

Put down the phone. Chances are the information you’re looking for is online. Listed in order of popularity, the resources featured below show you how to make the best use of our secure Web tools. Many are also included in our Provider Video Gallery.

  • Check claim status video . (2:44 min.)
  • Follow up on a denied claim with attachments video . (3:06 min.) 
  • Check benefit accumulations video . (3:30 min.)
  • Resolve possible workers’ compensation claims video . (3:18 min.)
  • Download provider claims remittances (PCR) presentation .
  • Get pre-service authorization resource page
  • Request pre-service review for out-of-area members video . (4:05 min.)
  • Create and submit a new claim video . (12 min.) 

Resources for DSCsResources for DSCs

Designated security coordinators play a unique role in Wellmark’s Web security protocol. There are two types of DSCs. The “main DSC” has several responsibilities, including signing Wellmark’s usage agreement on behalf of his or her organization. The second type is simply known as “DSCs.” Each organization has one main DSC, but he or she can assign the DSC role to any number of individuals. Both types of DSCs can assign roles to other users to access certain tools and resources on Wellmark.com. To be effective in their role and maintain their organization’s security access, DSCs should be familiar with the following:

Information and Web SecurityInformation and Web Security

We all understand the need to protect our patients’ privacy while serving them efficiently. The following resources help keep providers and our members informed about this important topic:

 


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